NURS 245 Comprehensive Final Exam Modules 1-7

Which statement by the person preparing for retirement indicates they may need specialized counseling and targeted education? a. "I'm so glad I'll have a pension to draw from." b. "I don't know what I'm going to do since practicing law has always filled my days." c. "I'm waiting until I'm eligible for Medicare so I can be sure to continue treatment for my heart failure." d. "I'm really looking forward to quitting this government job."

"I'm waiting until I'm eligible for Medicare so I can be sure to continue treatment for my heart failure."

A 70-year-old diabetic patient has just received instruction from a nurse on glucose self-monitoring. He tells the nurse: "I hear that those test strips cost a lot. I am not sure that I can afford anything else. The only health insurance I have is Medicare Parts A and B." The best response by the nurse is: a. "I am sorry, but Medicaid is the only insurance that covers the cost of diabetic testing supplies." b. "Medicare Part A will cover the cost of the supplies to manage your diabetes." c. "Medicare Part B will cover the cost of the supplies to manage your diabetes." d. "I am sorry, but Medigap insurance is the only insurance that covers the cost of diabetic testing supplies."

"Medicare Part B will cover the cost of the supplies to manage your diabetes."

A nurse is using the function-focused care approach to care for a hospitalized older adult. The nurse is assisting the patient to transfer from the bed to a chair. Which of the following statements by the nurse is most congruent with this approach to care? a. "Place your hands across your chest and let us move you to the edge of the bed." b. "Place both of your hands on the overbed trapeze and pull yourself up to a sitting position." c. "How do you get yourself out of bed when you are at home? Why can't you do the same thing here?" d. "It is taking you a long time to get yourself into a sitting position. Let me help you sit up."

"Place both of your hands on the overbed trapeze and pull yourself up to a sitting position."

An older woman asks a nurse, "You always seem to be telling me that I need to take in more fluids. How much fluid do I really need to drink?" The nurse bases her response on the knowledge that older adults should consume at least: a. 1000 mL of fluid per day. b. 1500 mL of fluid per day. c. 2000 mL of fluid per day. d. 2500 mL of fluid per day.

1500 mL of fluid per day

An older adult is diagnosed with Alzheimer's disease. The nurse knows that this diagnosis is made on the presence of which of the following? (Select all that apply.) a. A decline from a previous level of functioning b. Fluctuation of symptoms over the course of a 24-hour period c. An insidious onset d. A gradual decline in cognitive abilities e. The cognitive changes worsen in the evening hours

A decline from a previous level of functioning An insidious onset

. Which of the following are examples of elderspeak? (Select all that apply.) a. A nursing assistant refers to one of her patients as "grandma." b. A nurse attempts to medicate a patient and states, "Now come on and be a good girl." c. A nurse explains a procedure to a patient using simple nonmedical terms. d. A nurse makes sure that she is directly facing a patient who has hearing loss when she is speaking. e. A nursing assistant tells a patient, "It is time for our bath now."

A nursing assistant refers to one of her patients as "grandma." A nurse attempts to medicate a patient and states, "Now come on and be a good girl." A nursing assistant tells a patient, "It is time for our bath now."

Based on the census reports of 2015, the typical profile of a centenarian includes which of the following characteristics? a. An American woman with no signs of dementia b. A Japanese woman with chronic inflammation c. A Chinese man with an immune disorder d. An American man who is a lifelong vegetarian

An American woman with no signs of dementia

Which assessment finding is a contributor to an older client's risk for falls? (Select all that apply.) a. Client is awaiting cataract surgery on right eye. b. Client's type 2 diabetes is poorly controlled with diet and exercise alone. c. Client reports a fall in the last year. d. Client has a history of contact dermatitis and psoriasis. e. Client attends Tai Chi classes at the senior center.

Client is awaiting cataract surgery on right eye. Client's type 2 diabetes is poorly controlled with diet and exercise alone. Client reports a fall in the last year.

A 78-year-old patient has a history of osteoarthritis and lives alone in a two-story home. The bathroom is on the first level and the bedroom is on the second level. The patient states, "I am so upset. I have been wetting the bed at night." What type of incontinence does the patient most likely have? a. Mixed incontinence b. Stress incontinence c. Urge incontinence d. Functional incontinence

Functional incontinence

A community health nurse provides an annual flu prevention workshop at a local senior center. The activities include a lecture on preventing infections, which includes hand washing and limiting exposure to individuals who are ill, as well as an influenza immunization clinic. The nurse is basing her activities on what component of aging? a. Wear and tear b. Oxidative stress c. Inflamm-aging d. Free radical aging

Inflamm-aging

When a terminally ill client expresses a need "for something more to help me cope with the pain," the nurse bases the recommendation of meditation on which principle concerning this alternative therapy? a. It is efficient and usually takes less than 5 minutes to implement. b. It has been shown to decrease anxiety and depression. c. It improves cognitive abilities. d. It has been known to eliminate emotional distress.

It has been shown to decrease anxiety and depression

The cost of nursing home care is significant. The primary payer for nursing home care is: a. Medicare. b. Medicaid. c. Long-term care insurance. d. Medigap insurance.

Medicaid

A nurse identifies a need to assess a patient's cognitive status. The nurse chooses to use the clock-drawing test. The nurse knows that the patient must have which of the following abilities? (Select all that apply.) a. Number fluency b. Familiarity with analog clocks c. Ability to hear and see d. Ability to sit up for 10 minutes e. Ability to speak English

Number fluency Familiarity with analog clocks Ability to hear and see

The partner of a client comments, "Our sex life will certainly suffer now that he's had a heart attack." Which statement is the basis for the nurse's response? a. The client should no longer have sexual relations because of the demand on his heart. b. The energy expenditure during sex is equivalent to briskly climbing six flights of stairs. c. People with heart disease may reduce their sexual activity out of fear of their condition. d. The couple will benefit from attending a cardiac support group.

People with heart disease may reduce their sexual activity out of fear of their condition

Which of the following statements describing oral care for the older population is correct? a. Regular dental examinations can prevent tooth loss and improve the ability to chew healthful foods. b. Losing one's teeth is considered a normal part of the aging process. c. Oral malignancies seldom occur in older adults so oral examinations are of low priority. d. Preventative dental care is covered under Medicare.

Regular dental examinations can prevent tooth loss and improve the ability to chew healthful foods

A widowed grandmother is about to assume the role of custodial parent for her 6-year-old grandchild. Which intervention has priority when preparing the grandmother for long-term success in this new role? a. Reviewing the developmental milestones of childhood b. Identifying local sources of child counseling services c. Discussing the common challenges of parenting a 6 year old d. Teaching stress management and relaxation techniques

Teaching stress management and relaxation techniques

A client who reported "a problem sleeping" shows an understanding of good sleep hygiene by: a. doing 10 pushups before bed to encourage a "pleasant tiredness." b. seldom eating a bedtime snack. c. engaging in computer games as a pre-bed activity. d. avoiding daytime napping.

avoiding daytime napping

An older adult is referred to a geriatric nurse practitioner because of changes in memory and reports by family members that "there is something different about her." The nurse practitioner evaluates the older adult for potentially reversible causes for the changes, which include: (Select all that apply.) a. depression. b. delirium. c. osteoporosis. d. rheumatoid arthritis. e. medication side effects.

depression delirium medication side effects

The family member of a patient asks if vitamin C will prevent aging. In formulating an appropriate response, the nurse considers the: a. free radical theory. b. autoimmune theory. c. wear-and-tear theory. d. continuity theory.

free radical theory

While the older African American is at the highest risk for developing dementia, the nurse demonstrates an understanding of this disease process's risk factors when assessing this population's: a. weight and elimination patterns. b. heart rate and capillary refill status. c. genetic makeup. d. muscle strength and reflex times.

genetic makeup

When asked by new parents what the life expectancy is for their African American newborn, the nurse replies that, "2015 statistics indicate that your son: a. will have a life expectancy of approximately 65 years." b. can realistically expect to live into his late 80s." c. has a good chance of celebrating his 75th birthday." d. is likely to live into his late 90s."

has a good chance of celebrating his 75th birthday

A nurse is assessing an older adult's risk for falls. One of the questions that she asks is whether the older adult has fallen in the past year. She asks this because individuals who have fallen: a. have a higher risk of falling again than persons who did not fall in the past year. b. are more likely to sustain injuries if they fall again than persons who did not fall in the past year. c. have most likely developed a fear of falling as compared to persons who did not fall in the past year. d. are most likely to have a balance disorder as compared to persons who did not fall in the past year.

have a higher risk of falling again than persons who did not fall in the past year

An 89-year-old hospitalized female patient tells a nurse, "I go to the bathroom really often, but I manage this by not drinking too much before I go to bed so I can sleep for the night." The patient has no pain or discomfort with voiding. The nurse considers this finding to be: a: a. manifestation of urge incontinence. b. manifestation of a urinary tract infection. c. normal age-related change in an 89-year-old woman. d. manifestation of diabetes.

normal age-related change in an 89-year-old woman

An older widow who is a newly admitted resident of a long-term care facility develops a romantic relationship with a male resident. When the resident's daughter demands that the staff "put a stop to this sexual behavior right now," the nurse's response is based on the understanding that: a. such activity in a long-term care facility is inappropriate. b. older adults need to express love and intimacy. c. sexual desire is usually absent in older adults. d. sexual activity can be dangerous for older adults with chronic illnesses.

older adults need to express love and intimacy.

Which age-related change affects absorption? a. Reduced saliva b. Reduced body water c. Increased adipose tissue d. Reduced enzyme activity

reduced saliva

A nurse plans programs for older adults in a senior center. She asks a retired teacher to lead an art class and a retired nurse to assist with a health fair. The nurse is utilizing which theory of aging? a. Gerotranscendence b. Activity theory c. Role theory d. Continuity theory

role theory

When conducting an admissions interview with an older client, the nurse observes that the client pauses for a period of time before responding to the questions. The nurse responds to this client based on the assumption that the client is: a. exhibiting signs of mild cognitive impairment. b. nervous and having difficulty concentrating on the questions. c. reluctant to share information with someone with whom he or she has no relationship. d. sorting through his or her vast life experiences in order to answer appropriately.

sorting through his or her vast life experiences in order to answer appropriately

Which option is an example of elder exploitation? a. A homebound client is left alone for days at a time by the caregiver. b. An older client is smacked if he doesn't eat all of his food. c. A client diagnosed with Alzheimer's disease is bathed only twice a month. d. A homebound client can only get groceries by agreeing to pay for her neighbor's groceries, too.

A homebound client can only get groceries by agreeing to pay for her neighbor's groceries, too.

An older patient with dementia is referred for adult day services (ADS). The patient's daughter asks the nurse about the benefits of ADS. The nurse considers which of the following in formulating a response? (Select all that apply.) a. ADS are designed to provide social and some health services for older adults. b. ADS are covered under Medicare Part B. c. ADS offer respite services for caregivers from the responsibilities of caregiving. d. ADS often provide educational programs and support groups for caregivers. e. ADS are all staffed with registered nurses.

ADS are designed to provide social and some health services for older adults. ADS offer respite services for caregivers from the responsibilities of caregiving. ADS often provide educational programs and support groups for caregivers.

A nurse is assessing an older patient with new onset confusion. The nurse understands that in order to have a diagnosis of delirium, the patient must exhibit which of the following? (Select all that apply.) a. Acute onset of symptoms or fluctuating course b. Inattention c. Disorganized thinking d. Altered level of consciousness e. Flat affect

Acute onset of symptoms or fluctuating course Inattention Disorganized thinking Altered level of consciousness

A nurse in the ambulatory care setting is preparing to do an interview with a non-English-speaking client. The nurse secures an interpreter. In order to have the most effective interview, the nurse should do which of the following? (Select all that apply.) a. Look and speak to the interpreter. b. Use technical terminology to ensure accuracy. c. Allow more time for the interview. d. Watch the client's nonverbal communication. e. Have the interpreter check whether the client understands the communication.

Allow more time for the interview. Watch the client's nonverbal communication. Have the interpreter check whether the client understands the communication.

An older patient is diagnosed with RLS/WEB. Which of the following nonpharmacologic interventions should the nurse include in the plan of care? (Select all that apply.) a. Engage in regular mild to moderate physical activity including stretching activities for the lower extremities. b. Avoid caffeine, alcohol, and tobacco. c. Avoid hot baths. d. Relaxation techniques may be helpful. e. A mild sleeping medication such as diphenhydramine (Benadryl) might be helpful.

Engage in regular mild to moderate physical activity including stretching activities for the lower extremities Avoid caffeine, alcohol, and tobacco Relaxation techniques may be helpful

A nurse implements a nursing care plan for a patient with constipation. Which of the following should the nurse include in the plan? a. Increasing fiber in the diet b. Administering aluminum hydroxide antacids c. Bed rest d. Restricting fluids

Increasing fiber in the diet

A nurse is conducting an assessment of an older adult in a geriatric clinic. The patient states that he drinks two to three alcoholic beverages daily. The patient has multiple chronic comorbid conditions and is on five different medications. Which of the following medications is the nurse concerned will interact with the alcohol? (Select all that apply.) a. Naproxen for pain b. Daily multivitamin c. Prozac for depression d. Celebrex for arthritis e. Toprol XL for hypertension ANS: A, C, E

Naproxen for pain Prozac for depression Toprol XL for hypertension

What intervention should a nurse implement when an older male diagnosed with dementia is observed masturbating in the unit's dayroom? a. Remove the resident from the dayroom and complete an assessment of his behavior. b. Cover the resident's lap with a blanket and leave him in the dayroom. c. Counsel the resident by telling him that his behavior is inappropriate. d. Distract the resident so that he will stop the behavior.

Remove the resident from the dayroom and complete an assessment of his behavior

A nurse is caring for an older adult who has a gastrostomy tube. The nurse is developing a care plan related to oral care. Which of the following should the nurse consider for this patient? (Select all that apply.) a. Oral care should be provided every 4 hours. b. Teeth should be brushed with a toothbrush at least twice a day. c. Lemon glycerin swabs should be used in between feedings to keep the mouth moist. d. Foam swabs should be used in place of a toothbrush to clean the teeth after each tube-feeding. e. Use a soft toothbrush dipped in alcohol-free mouthwash.

Teeth should be brushed with a toothbrush at least twice a day Use a soft toothbrush dipped in alcohol-free mouthwash

Which intervention to manage a wandering client in a long-term care facility should be implemented? Select all that apply. a. Walk with the person, allowing them control within the bounds of safety. b. Redirect the person back toward the facility. c. Call the person by his or her formal name. d. Using physical restraints to prevent wandering to maintain safety. e. Make direct eye contact with the person.

Walk with the person, allowing them control within the bounds of safety. Redirect the person back toward the facility. Call the person by his or her formal name. Make direct eye contact with the person.

A 79-year-old client resides independently in the community. The visiting home health nurse finds that despite it being 90° F outside, the windows are closed and the client is wearing a sweater. The nurse initially recognizes that this behavior may be related to: a. cognitive changes that diminish the individual's awareness of temperature changes. b. age-related neurosensory changes that diminish awareness of temperature changes. c. a delirium-related acute illness that is affecting body heat production. d. age-related motor deficiencies that result in self-neglect.

age-related neurosensory changes that diminish awareness of temperature changes

A 78-year-old patient who is dying of colon cancer with metastases to the liver is refusing to eat or drink. He is alert and oriented, and states that he has no desire to eat, which is causing the family great distress. In order to best address the client and family, the nurse should: a. explain the family's concern to the client. b. educate the family that this is normal behavior in this situation. c. contact the physician for an order for enteral feeding. d. contact the dietitian for feeding supplements.

educate the family that this is normal behavior in this situation

The area in which nurses have the greatest effect on the safe, effective medication therapy of an older client is: a. educating the client to all aspects of the medication. b. assessing for adverse reactions to the medication. c. monitoring overall health of the client as it is affected by the medication. d. evaluating the outcomes resulting from the medication.

educating the client to all aspects of the medication

An older female patient tells a nurse the following: "In my culture, women are the silent partner in the family. Men make all of the decisions. However, when we came to the United States, all that changed. I became an American. I am in charge of my family just like my husband." This is an example of: a. enculturation. b. acculturation. c. ethnicity. d. culture competence.

enculturation

A paper on culture and illness would be likely to include the statement that: a. culture is the same as ethnicity. b. ethnic groups always share common geographic origin and religion. c. ethnicity involves recognized traditions, symbols, and literature. d. most members of an ethnic group exhibit identical cultural traits.

ethnicity involves recognized traditions, symbols, and literature

The Beers Criteria is an effective tool for health care professionals prescribing and/or managing the medication therapy of older adults since it identifies medications that for this population: a. are not typically covered by drug benefit plans. b. have a higher than usual risk for injury. c. are likely to be abused. d. generally cause allergic reactions.

have a higher than usual risk for injury

Symptoms of gastroesophageal reflux disease (GERD) in older adults include: (Select all that apply.) a. heartburn. b. regurgitation. c. abdominal pain within 1 hour of eating. d. vomiting. e. fever and elevated white blood cell count.

heartburn. regurgitation. abdominal pain within 1 hour of eating.

A patient tells a nurse that she has prepared a living will (LW). The nurse understands that a living will: (Select all that apply.) a. is an advanced directive that is used in the situation of a person who is unable to speak for herself or himself. b. is a legally binding document in all states and territories of the United States. c. appoints a proxy to uphold the patient's wishes. d. includes the provision that the patient's next of kin have more authority than the appointed proxy. e. can be revoked by the patient at any time in either writing or verbally.

is an advanced directive that is used in the situation of a person who is unable to speak for herself or himself. appoints a proxy to uphold the patient's wishes. can be revoked by the patient at any time in either writing or verbally.

Baby boomers born before 1960 were subject to which of the following health challenges during their childhood? (Select all that apply.) a. Measles b. Scarlet fever c. Rubella d. Smallpox e. HIV/AIDS

measles, scarlet fever, and rubella

A nurse in a long-term care facility notes that an older resident with dementia awakens frequently at night and is restless and agitated. Which of the following interventions will be most effective to help manage this resident's sleep problems? a. Passive music therapy at bedtime b. Limiting fluid intake for the resident c. Educating the resident on the association between dementia and insomnia d. Administering a mild sedative hypnotic at bedtime

passive music therapy at bedtime

A frail, elderly widow is admitted to the hospital after sustaining a fall. The client lives alone and has no living relatives. After cognitive testing reveals mild cognitive impairment, the interdisciplinary team on the Acute Care for the Elderly Unit recommends long-term care placement and that a durable power of attorney for health care (DPOA-HC) be established. When the client seems confused over what a DPOA-HC's responsibilities are, the nurse responds that: a. "A DPOA-HC is a person you name to make health care decisions for you when you can't make them for yourself." b. "A DPOA-HC is a person you trust to make financial decisions for you and to manage your money." c. "A DPOA-HC is a person appointed by the court to make sure you get good care and to manage your affairs." d. "A DPOA-HC is a person who is appointed by the court to make nursing home placement decisions for your care."

"A DPOA-HC is a person you name to make health care decisions for you when you can't make them for yourself."

An older adult is concerned that if her spouse, who recently suffered a stroke, is placed in a nursing home, "they will take everything in order to pay for his care." What response will the nurse make? a. "A spouse is allowed to keep a percentage of the family income and cash as well as the family home, car, and personal property" b. "You should consider transferring the assets to your son so that your husband will qualify for Medicaid" c. "Have you considered caring for your husband at home since Medicare will cover custodial care at home?" d. "Are you aware that your children have a legal obligation to provide financial support toward the care of disabled parents?"

"A spouse is allowed to keep a percentage of the family income and cash as well as the family home, car, and personal property"

Which question has priority when assessing a client for risk factors related to the use of sildenafil (Viagra)? a. "How old are you?" b. "Are you currently being treated for hypertension?" c. "Do you have a history of respiratory infections?" d. "Have you ever been told you have prostate problems?"

"Are you currently being treated for hypertension?"

A nurse who is caring for an older patient with bipolar disorder knows that the patient needs additional education when the patient states: a. "Bipolar disorder often results in 'a leveling out' of symptoms as one ages." b. "Relapses in bipolar disorder tend to be precipitated by medical problems." c. "The length of the phases of depression and mania varies." d. "Bipolar disorder is the most commonly diagnosed psychiatric disorder in older adults."

"Bipolar disorder is the most commonly diagnosed psychiatric disorder in older adults."

. Which question will best assess the ability of the LGBT older couple to successfully adjust to the challenges of aging? a. "How long have you been in this relationship?" b. "Can you tell me about your support system?" c. "As a couple are you financially secure?" d. "Do you as a couple share similar religious beliefs?"

"Can you tell me about your support system?"

A nurse in a long-term care facility is approached by an older resident who is crying and states: "You need to help me. The mean little men are in my room again. They are watching me from the corner and they are laughing at me. Make them go away." The nurse accompanies the resident to the room and there is no one in the corner of the room. What is the best response by the nurse? (Select all that apply.) a. "Yup, I see them. Let me call security to haul the men away." b. "Can you tell me what you are so frightened of?" c. "I will do my best to keep you safe." d. "I understand that you are very frightened and upset." e. "You know that there is no one there. Stop carrying on like this."

"Can you tell me what you are so frightened of?" "I will do my best to keep you safe." "I understand that you are very frightened and upset."

How should the nurse reply when an older adult asks, "How much alcohol is good for you? a. "Alcohol isn't good for you so avoid it as a general rule." b. "Experts in the field recommend only one regular sized drink a day." c. "It's been said that red wine has health benefits, but that doesn't mean drink a whole bottle." d. "If you are only drinking on special occasions, limit yourself to two drinks."

"Experts in the field recommend only one regular sized drink a day."

An older woman is preparing to move in with her daughter following the death of her spouse of 55 years. The daughter asks a nurse, "I know we are doing the right thing for mom, but I am a bit nervous about this. Do you have any suggestions about things that we should do in preparation?" The nurse responds: (Select all that apply.) a. "Have you chosen an area of the house for your mom to live in?" b. "Have you considered scheduling regular visits for your mom with your sister who lives out of state?" c. "You have every right to be nervous; multigenerational households are usually not successful." d. "Have you investigated what activities are available at the senior center near your home?" e. "Since your mom is so computer literate she can stay in touch with her friends when she moves."

"Have you chosen an area of the house for your mom to live in?" "Have you considered scheduling regular visits for your mom with your sister who lives out of state?" "Have you investigated what activities are available at the senior center near your home?" "Since your mom is so computer literate she can stay in touch with her friends when she moves."

An older adult is considering residential care/assisted living (RC/AL). The nurse knows that the older adult needs additional teaching when the older adult states which of the following? a. "I read a recent article that stated that more older adults would prefer to move to an assisted living community than a nursing home if they could no longer care for themselves." b. "I am happy that Medicare pays for the cost of living in an RC/AL." c. "I will have to check with my long-term care insurance company. I heard that it might pay for RC/AL." d. "RC/AL costs significantly less than nursing home care."

"I am happy that Medicare pays for the cost of living in an RC/AL"

The daughter of a patient who has a chronic illness that has reached the terminal phase talks about the palliative care referral that the primary care provider made for her mother. Which of the following statements indicate that the daughter needs additional education about palliative care? (Select all that apply.) a. "I know that palliative care is only available to people who have 6 months or less to live. That is really hard to cope with." b. "My mom still can be actively treated while receiving palliative care." c. "I understand that the palliative care team is made up of health care professionals of all different disciplines, not just doctors and nurses." d. "The goal of palliative care is to prevent or to minimize suffering" e. "My mom will have to be transferred to a special unit in the hospital in order to receive palliative care."

"I know that palliative care is only available to people who have 6 months or less to live. That is really hard to cope with." "My mom will have to be transferred to a special unit in the hospital in order to receive palliative care."

. Which nursing statement shows a true appreciation for an older client's willingness to tell his personal stories about "the war"? a. "It's so nice to see them excited and engaged as they tell the stories." b. "It helps their memory so much to retell their stories." c. "I learn so much about clients when they share their life story with me." d. "They are so proud of the things they have accomplished in their life."

"I learn so much about clients when they share their life story with me."

Which statement made by the resident of a long-term care facility is evidence that the facility is providing care in accordance with the Bill of Rights for long-term care residents? a. "It's so nice to have my hometown newspaper available here." b. "Going out to the theater with the other residents is a nice social activity." c. "I was told that if I didn't want to change rooms, I didn't have to." d. "The whole place was decorated so beautifully for the holidays."

"I was told that if I didn't want to change rooms, I didnt have to"

Which statements made by a couple who have recently retired support the nurse's evaluation that the transition to retirement has been a successful one? (Select all that apply.) a. "I'm afraid we can't make it that weekend; we'll be visiting the grandchildren." b. "I'm not accustomed to sharing my kitchen with anyone else." c. "One week I was working 50 hours and the next I didn't have to get up until noon." d. "I often wonder if my buddies from the plant miss me." e. "We have found a few painless ways to reduce our monthly expenses."

"I'm afraid we can't make it that weekend; we'll be visiting the grandchildren." "We have found a few painless ways to reduce our monthly expenses."

When an older adult client is diagnosed with restless leg syndrome/Willis-Ekbom Disease (RLS/WED), the nurse is confident that client education on the condition's contributing factors has been effective when the client states: a. "A warm bath at night instead of in the morning is my new routine." b. "Eating a banana at breakfast assures me the potassium I need." c. "I've cut way back on my caffeinated coffee, teas, and sodas." d. "I elevate my legs on a pillow so as to improve circulation."

"I've cut way back on my caffeinated coffee, teas, and sodas."

Which statement made by a nurse regarding a resident of a long-term care facility requires follow-up by the nurse manager? a. "If he doesn't take his medication, he'll get no dessert tonight." b. "She can't take a walk outdoors today; it's much too cold and snowy." c. "The grandchildren have colds so they should not visit this week." d. "I don't understand why, but she wants a different doctor to see her."

"If he doesn't take his medication, he'll get no dessert tonight."

An older man who recently had a myocardial infarction is being discharged home from the hospital. He tells a nurse, "I am really worried about having sex with my wife. I am afraid that I am going to have another heart attack." The best response by the nurse includes which of the following? (Select all that apply.) a. "If you are able to engage in mild to moderate physical activity without symptoms, you can resume sexual activity." b. "You really should not engage in sexual activity until 3 months have passed post heart attack." c. "It is best if you avoid eating a large meal for several hours before you have sexual relations." d. "If you have chest pain while having sex, stop and rest, and take your nitroglycerin." e. "You might want to consider some alternate positions that avoid strain."

"If you are able to engage in mild to moderate physical activity without symptoms, you can resume sexual activity." "It is best if you avoid eating a large meal for several hours before you have sexual relations." "If you have chest pain while having sex, stop and rest, and take your nitroglycerin." "You might want to consider some alternate positions that avoid strain."

A Navy war veteran is seeking advice about getting treatment for a chronic respiratory problem at the local veterans' hospital. The nurse's initial response is to ask: a. "Why aren't you considering the local general hospital for the care that you need?" b. "Are you willing to travel to a veterans' hospital that offers respiratory diagnostic services?" c. "Have you ever been treated at a veterans' hospital before?" d. "Is the problem related to something that occurred while you were in the Navy?"

"Is the problem related to something that occurred while you were in the Navy?"

Which statement by the nurse is the strongest example of ageism by professional nurses? a. "It takes a special nurse to provide good care to the older population of clients. " b. "It's difficult for a nurse to develop an effective relationship with an older client because of the barriers their age creates." c. "It is so difficult to find nurses who are truly effective geriatric nurses." d. "With the older population increasing so dramatically in numbers, nursing will have a difficult time meeting their needs."

"It is so difficult to find nurses who are truly effective geriatric nurses."

An older client diagnosed with dementia resides with his daughter. When the homecare nurse visits, the daughter tearfully tells the nurse that her father scratched her hand and cursed at her when she was attempting to feed him. She states, "I don't know why he hates me and wants to hurt me. I try so hard to take good care of him. I love him." How will the nurse respond to the client's daughter? a. "Let's think about what you may have done to anger your father?" b. "Let's try to figure out what your father was trying to say with his behavior." c. "Scratching is usually a sign of untreated pain. Do you think your father is in pain?" d. "Maybe you should consider having a home health care provider take over responsibility for your father's physical care."

"Let's try to figure out what your father was trying to say with his behavior."

Which of the following statements made by a family caregiver would a nurse consider most indicative of elder abuse? a. "I get so frustrated because my father used to be so competent and now cannot even feed himself." b. "Mom cannot pay her own bills anymore. We went to the bank and arranged for me to have access to her checking account and help her pay the bills." c. "My dad wanders at night and I can't be bothered with him. I mix sleeping pills in his dinner so that he will fall asleep." d. "Mom asks me to do everything for her, but I think it is better if she keeps on

"My dad wanders at night and I can't be bothered with him. I mix sleeping pills in his dinner so that he will fall asleep."

Which statement best demonstrates an older adult's success at achieving self-actualization? a. "My father was an alcoholic, but he did love us." b. "I always feel safe when my son is visiting." c. "My heart problems are better since I had the surgery." d. "I've been elected president of my service organization again."

"My father was an alcoholic, but he did love us."

When a cognitively impaired, wealthy, white client is noted to have burns on her upper back, her son states that the patient burned herself when attempting to shower. Which statement by a member of the team reflects a need for further education on elder abuse? (Select all that apply.) a. "She is wealthy; abuse does not happen in people of financial means." b. "Even if we are not sure, we are legally bound to report our suspicions." c. "We need to consider that most abusers are either adult children or spouses." d. "Her cognitive deficiencies put her at risk for elder abuse." e. "The client is white and race places an important role in who is likely to be abused."

"She is wealthy; abuse does not happen in people of financial means" "The client is white and race places an important role in who is likely to be abused."

An older patient asks a nurse, "I really have trouble sleeping and my doctor does not want to prescribe a sleeping pill for me. He says they are not good for older people. I really don't understand his response. Can you help me?" The best response by the nurse is: a. "Sleeping medications have many adverse effects in older people and only have minimal effects in improving sleep." b. "Prescription sleeping medications have many adverse effects in older people. Why don't you try using an over-the-counter medication?" c. "Sleeping medications do not provide any improvement in sleep for older people." d. "Sleep problems are common in older people. There really is nothing that you can do to help with that."

"Sleep medications have many adverse effects in older people and only have minimal effects in improving sleep."

An older client in an adult day care program tells the nurse, "I'm very stressed because another neighbor passed away." The most therapeutic response by the nurse is: a. "You are experiencing grief, not stress." b. "Tell me what you did when your other neighbor passed away." c. "Are you worrying about your own death?" d. "Let's get involved in some activities and not think about sad things."

"Tell me what you did when your other neighbor passed away."

A nurse is admitting and orienting an older adult to the hospital unit. She discusses fall prevention and demonstrates the use of the call bell to the patient. The patient's daughter asks: "Why don't you just put up all the side rails to prevent my mother from getting out of bed by herself and falling. That should work, right?" The best response by the nurse is: a. "Side rails have only proven to be effective in decreasing falls in patients who have already fallen." b. "There is no evidence that side rail use decreases falls, and in fact there is a greater risk of injury." c. "Side rails are only effective when used with patients who have dementia." d. "Side rails do not decrease falls, but they do decrease fall-related injuries."

"There is no evidence that side rail use decreases falls, and in fact there is a greater risk of injury".

When discussing electroconvulsive therapy (ECT) with an older, chronically depressed adult and his family, which statement will the nurse use to support this intervention? (Select all that apply.) a. "This treatment has been shown to be effective in individuals who have not responded well to antidepressant medications." b. "ECT is contraindicated in frail adults with multiple comorbidities." c. "ECT is a safe intervention for those with psychotic ideation." d. "ECT is the most effective treatment for older adults with major depression." e. "ECT results in a more immediate reduction in depressive symptoms."

"This treatment has been shown to be effective in individuals who have not responded well to antidepressant medications." "ECT is the most effective treatment for older adults with major depression." "ECT results in a more immediate reduction in depressive symptoms."

A nurse practitioner is using the PLISSIT model to guide a discussion of sexuality with an older patient in the geriatric clinic. Which of the following are congruent with the PLISSIT model? (Select all that apply.) a. "What concerns or questions do you have about fulfilling your sexual needs?" b. "Let me tell you about the impact of your cardiac disease on sexual activity." c. "I have a few suggestions on lubricants that might make intercourse more comfortable for you." d. "Most older adults are not comfortable talking about sexuality, but it is important to do so." e. "It is not unusual to have difficulty performing sexually as you age."

"What concerns or questions do you have about fulfilling your sexual needs?" "Let me tell you about the impact of your cardiac disease on sexual activity." "I have a few suggestions on lubricants that might make intercourse more comfortable for you."

5. A nurse is working with an older individual who has recently started an exercise program. The individual tells the nurse, "This exercise thing is really hard, and I absolutely hate walking on a treadmill going nowhere. I think I am going to call it quits." Which of the following responses by the nurse will be most effective in encouraging the individual to remain in the program? a. "If you stop exercising, you will reverse all the good effects that the exercise accomplished." b. "I will have to report that to your physician." c. "What types of exercise do you enjoy doing?" d. "Most older people hate exercising, but they do it anyways."

"What types of exercise do you enjoy doing?"

A nursing student asks the instructor, "Our textbook discussed the obesity paradox in older adults. I am not sure I understand; isn't obesity bad for everyone?" The best response by the instructor is: a. "While there is evidence that obesity in younger people lessens life expectancy, overweight and obese adults do not have the same risk of morbidity and mortality. b. "Obesity is usually not a concern in older adults, as most older people tend to weigh less than they did when they were younger." c. "Obesity is a concern in all age groups; however, over the past decade obesity in older adults has decreased." d. "Obesity in older adults is less of a concern than we once thought; individuals over age 65 with a higher BMI have a lower mortality rate."

"While there is evidence that obesity in younger people lessens life expectancy, overweight and obese adults do not have the same risk of morbidity and mortality.

A 75-year-old female asks a nurse "I know I should be moving, but how much is the right amount of exercise for me?" The best response of the nurse is: a. "You need to engage in 30 minutes of moderate intensity exercise several days a week." b. "You need to engage in at least 30 minutes of moderate intensity exercise every day of the week." c. "Since you are 75, the recommendations are 30 minutes of moderate exercise three times a week." d. "There are no specific recommendations for someone of your age; just keep moving."

"You need to engage in 30 minutes of moderate intensity exercise several days a week."

Following the death of her husband, the client states, "How will I go on? I just don't know how I can live without him." What is the best response by the nurse? a. "Many people have lost their spouse and have done well. You will too." b. "Don't worry. Your family will help you get through this." c. "You're going to get through this one day at a time and I will be there to help you." d. "Look on the bright side. Your husband is no longer suffering."

"You're going to get through this one day at a time and I will be there to help you."

A nurse understands that the pathophysiology of Parkinson's disease includes which of the following? (Select all that apply.) a. A deficiency of the neurotransmitter dopamine b. An inability of the neurons to absorb dopamine c. A reduction of dopamine receptors d. An accumulation of Lewy Bodies, especially in the basal ganglia e. The presence of neurofibrillary tangles and amyloid plaques in the brain

A deficiency of the neurotransmitter dopamine A reduction of dopamine receptors An accumulation of Lewy Bodies, especially in the basal ganglia

An 81-year-old patient is being discharged from the hospital to home. She is on seven different medications, which are to be taken at four different times during the day. What would be most useful in helping this patient manage her medications? a. The package inserts from all of the medications for the client to read b. A pillbox with compartments for each day and each of the doses c. A written list of all the client's medications and administration routine d. A suggestion that the client's daughter administer the medications

A pillbox with compartments for each day and each of the doses

A 70-year-old person who has Medicare Part A only is discussing the cost of health care with a nurse. The nurse understands that Medicare Part A covers the cost of which of the following? (Select all that apply.) a. Diabetic testing supplies b. Acute hospitalization semiprivate rooms c. Intensive care unit hospitalization d. Skilled rehabilitative nursing care in a health care facility e. Prescription medications

Acute hospitalization semiprivate rooms Intensive care unit hospitalization Skilled rehabilitative nursing care in a health care facility

What is the role of the nurse in assisting older adults with travel interests? a. Suggesting that they travel with a seniors' group b. Addressing arrangements to have medical care, if needed, during their travels c. Providing information regarding pet care services for their beloved dog d. Reassuring the client that their concerns about safety are unfounded

Addressing arrangements to have medical care, if needed, during their travels

A nurse is caring for an older adult with Parkinson's disease. The patient is receiving the medication levodopa-carbidopa. The nurse understands that in order to maximize effectiveness, the administration schedule for this medication should adhere to which of the following? a. Administer with meals only b. Administer first thing in the morning only c. Administer on an empty stomach, 30-60 minutes before or 45-60 minutes after a meal d. Administer with a full 8 oz of water and have the patient sit upright for 30 minutes after

Administer on an empty stomach, 30-60 minutes before or 45-60 minutes after a meal

A nurse is caring for a 92-year-old female patient who was admitted to the hospital 1 day after she had outpatient cataract surgery. The patient who lives in an assisted living facility became very confused and agitated and was found wandering in the lobby of the building in her nightgown. She refused to return to her room and stated that there were "bad men" in her room. The patient has a history of dementia, diabetes, heart failure, and is on seven different medications. She was widowed 1 year ago. The nurse suspects that she has delirium. What are the patient's risk factors for delirium? (Select all that apply.) a. Age of 92 b. Residing in an assisted living facility c. History of dementia d. Female gender e. Recent cataract surgery

Age of 92 History of dementia Recent cataract surgery

A nurse suspects elder mistreatment in which of the following patients seen in the emergency department? (Select all that apply.) a. An 85-year-old male with cardiac disease who is taking blood thinners and has multiple bruises on his arms and hands. b. An 86-year-old female nursing home resident admitted to the hospital with vaginal bleeding and three large bruises on her inner c. A 77-year-old woman who fell at home and broke her arm after tripping over her cat. d. A 73-year-old man with a history of gastric ulcers who is vomiting blood and found to be anemic and has a low BMI. e. A 69-year-old man with a history of diabetes who is admitted for diabetic foot ulcers wearing dirty clothing and smells like urine.

An 86-year-old female nursing home resident admitted to the hospital with vaginal bleeding and three large bruises on her inner A 69-year-old man with a history of diabetes who is admitted for diabetic foot ulcers wearing dirty clothing and smells like urine.

Primary prevention strategies for older adults include which of the following? (Select all that apply.) a. An annual influenza immunization clinic b. A smoking cessation program c. A prostate screening program d. A cardiac rehabilitation program e. A meal planning education program for type 2 diabetics

An annual influenza immunization clinic A smoking cessation program

Which description would be most characteristic of a self-actualized individual? a. An economically disadvantaged older black man who regularly checks out books from the local library to read to neighborhood children. b. A wealthy white older woman who is constantly searching for a better laxative. c. A middle-class white man who was forced into an early retirement and is living in fear of being evicted from his apartment. d. The older wife of a famous celebrity who travels the world but starves herself and seeks plastic surgery in her quest to fight the physical signs of aging.

An economically disadvantaged older black man who regularly checks out books from the local library to read to neighborhood children.

Which intervention fosters the grieving client's movement from disequilibrium and instability to a new steady state? (Select all that apply.) a. Answering the client's questions regarding the trajectory of his or her illness b. Offering to pray with the client and family c. Scheduling a meeting with the client and family to identify alternative end-of-life plans d. Encouraging the client to cry when they feel like it e. Being available to just listen to the client talk about dying

Answering the client's questions regarding the trajectory of his or her illness Scheduling a meeting with the client and family to identify alternative end-of-life plans Encouraging the client to cry when they feel like it Being available to just listen to the client talk about dying

Which intervention best demonstrates that the nurse understands the spiritual needs of a terminally ill client? a. Arranging care so that the client's prayer time is not interrupted b. Assuming the responsibility of notifying the hospital chaplain of the client's admission c. Providing the client with the schedule of religious services offered in the chapel d. Suggesting that the family attend worship services with the client whenever possible

Arranging care so that the client's prayer time is not interrupted

Which intervention demonstrates effective care for an individual who has expressed a wish to "retire sometime soon"? (Select all that apply.) a. Asking about when she plans to retire b. Assessing her ability to handle the stresses of retirement c. Engaging her in a conversation about her interests d. Inquiring about the existence of any chronic illnesses e. Scheduling a full physical examination

Asking about when she plans to retire Assessing her ability to handle the stresses of retirement Engaging her in a conversation about her interests Inquiring about the existence of any chronic illnesses Scheduling a full physical examination

Which of the following nursing actions would help minimize the psychosocial impact of bladder and/or bowel incontinence for individuals experiencing incontinence prior to going to a group dining room? a. Assess for soiled clothing and change, if necessary. b. Toilet the client and then promptly transport to the dining room. c. Provide pericare and fresh underclothing. d. Ask the client if toileting is needed and assist as necessary.

Assess for soiled clothing and change, if necessary.

A 74-year-old woman who is in the hospital for rehabilitation following hip replacement has been experiencing incontinence since admission. Which of the following interventions are likely to facilitate the restoration of the patient's bladder function? (Select all that apply. a. Assess the patient's recent voiding pattern. b. Request an order for an indwelling catheter from the patient's physician. c. Teach the patient how to meet hydration needs while still limiting fluid intake. d. Assist the patient to use the bathroom. e. Request an order for medication to decrease bladder spasms.

Assess the patient's recent voiding pattern. Assist the patient to use the bathroom.

An older adult client has been voluntarily admitted for treatment of alcohol dependency. In implementing care, the nurse plans which intervention based upon knowledge about alcohol and aging? a. Assessing the client for both depression and anxiety b. Discussing the poor prognosis of this disorder with the client c. Explaining the need for proper nutrition to minimize the effects of alcoholism d. Identifying the effects of chronic alcoholism on the human body

Assessing the client for both depression and anxiety

A nurse in a long-term care facility is concerned that a 94-year-old resident with dementia is losing weight. Upon assessment, the nurse notes that the resident, who is able to feed herself independently, consumes less than 50% of each of her meal trays. Which of the following strategies can the nurse utilize to improve this resident's intake? (Select all that apply.) a. Assign a nursing assistant to feed the resident. b. Assign a nursing assistant to sit with the resident as the resident eats. c. Serve the resident finger foods. d. Serve the resident one dish at a time. e. Alter the dining ambience to reduce distractions.

Assign a nursing assistant to sit with the resident as the resident eats. Serve the resident finger foods. Serve the resident one dish at a time. Alter the dining ambience to reduce distractions.

. Which intervention best addresses the principle that is the basis for communicating with a client experiencing postsurgical delirium? a. Reminding the client that delirium is generally acute and reversible b. Assuming that the client's statements are an attempt to express needs c. Allowing the client sufficient time to formulate an answer to questions d. Using nonverbal communication techniques to communicate with the client

Assuming that the client's statements are an attempt to express needs

A nurse is developing an educational session for a group of older adults at a senior center. Which of the following would the nurse include in the education? a. Attention span, language, and communication skills typically remain stable with increasing age. b. Older brains slow down and take longer to process constantly increasing amounts of information. c. In order to preserve brain function, it is important to engage in challenging cognitive activities. d. Older adults are not able to develop new cognitive abilities. e. Individuals over age 100 have a higher prevalence of dementia than younger individuals.

Attention span, language, and communication skills typically remain stable with increasing age. Older brains slow down and take longer to process constantly increasing amounts of information. In order to preserve brain function, it is important to engage in challenging cognitive activities.

A nurse is performing preoperative teaching for an older adult who is scheduled to have a cataract extraction and lens implant. The nurse includes which of the following in the teaching plan? (Select all that apply.) a. Avoid lifting heavy objects after the surgery. b. Avoid bending from the waist after the surgery. c. Take stool softeners as needed. d. Maintain strict control of your blood sugar and blood pressure. e. Maintain a dry sterile dressing over the eye for 10 days.

Avoid lifting heavy objects after the surgery. Avoid bending from the waist after the surgery. Take stool softeners as needed.

A nurse working in an emergency department is caring for an 89-year-old woman who was brought to the hospital by her daughter for a fracture of the right arm. The woman is wheelchair dependent and lives with her widowed daughter who is the primary caregiver. The daughter states that her mother got up out of the wheelchair unassisted to go to the bathroom and fell. The patient cannot recall the circumstances of the fall. The patient is weeping and cradling her right arm. The patient's history reveals two previous wrist fractures over the course of the past year. The nurse notes several large ecchymotic areas on the right hand and left arm and on the left side of the body and the back. The ecchymoses are in various stages of healing. Upon assessment, the patient is non-weight-bearing (NWB). The nurse suspects physical abuse based on which of the following findings? (Select all that apply.) a. Bruises are in various stages of healing. b. The fracture is inconsistent with the patient's functional ability. c. Caregiver suffering stress from for a functionally dependent individual. d. Patient is crying. e. Patient has a history of previous wrist fractures.

Bruises are in various stages of healing. The fracture is inconsistent with the patient's functional ability.

The nurse is providing care to a client diagnosed with dementia. What option is an example of the appropriate use of implied consent by the nurse? a. Preparing to draw blood from a client's arm after asking, "Can I see your arm?" b. Changing the client's dressing when the client asks, "Will you change this bandage now?" c. Using the client's monthly allowance to buy a watch when he continuously asks for the time d. Arranging for a benign mole to be removed after the client states, "I don't like this here."

Changing the client's dressing when the client asks, "Will you change this bandage now?"

A nurse suspects that her next-door neighbor, an older woman, is a victim of elder abuse by her daughter. What is the appropriate action for the nurse to do in this situation? a. Because the neighbor is not a patient, the nurse should not get involved. b. Visit the neighbor frequently to confirm the suspicions. c. Complete a confidential report with the adult protective services in the area. d. Ask the neighbor herself if she is being abused.

Complete a confidential report with the adult protective services in the area

A nurse caring for an older hospitalized woman is concerned about promoting functional status. Which of the following interventions should the nurse include in this patient's plan of care? (Select all that apply.) a. Conduct a baseline functional status assessment of the patient. b. Request a physical therapy referral. c. Make sure that the patient has all activities of daily living performed for her. d. Progressive mobility interventions. e. Encouraging the patient to feed herself.

Conduct a baseline functional status assessment of the patient Request a physical therapy referral Progressive mobility interventions Encouraging the patient to feed herself

Which information will the nurse manager include when discussing the major differentiation between delirium and dementia with novice nurses? (Select all that apply.) a. The delirious client learns to make up answers to hide his or her confusion. b. Delirium requires increased monitoring at night. c. The client diagnosed with dementia generally looks frightened. d. Dementia results in a steady decline in cognitive abilities. e. Delirium is characterized by fluctuations in alertness.

Delirium requires increased monitoring at night. Dementia results in a steady decline in cognitive abilities. Delirium is characterized by fluctuations in alertness.

Which precaution would be beneficial in minimizing an older adult's risk of being a victim of fraud? (Select all that apply.) a. Do not allow uninvited salespersons into your home. b. Never provide personal information to telephone sales solicitors. c. Rely on the advice of people who only friends have recommended. d. Contact the local Medicare or Medicaid service office for information when needed. e. Keep your bank account and credit card numbers with you at all times.

Do not allow uninvited salespersons into your home. Never provide personal information to telephone sales solicitors. Contact the local Medicare or Medicaid service office for information when needed.

A nurse is educating a group of older adults on the benefits of an exercise program. The nurse includes education on when not to exercise. Which of the following should the nurse include in the education? (Select all that apply.) a. Do not exercise if your resting heart rate is over 80. b. Do not exercise if your blood pressure is greater than 200 systolic and 100 diastolic. c. It is important to wait 30 minutes after a big meal before engaging in vigorous exercise. d. Do not exercise if a joint that you are using to exercise is red, warm, and painful. e. Do not exercise if you have a fever and muscle aches.

Do not exercise if your blood pressure is greater than 200 systolic and 100 diastolic. Do not exercise if a joint that you are using to exercise is red, warm, and painful. Do not exercise if you have a fever and muscle aches.

What information should be included in an informational program to be presented on burn prevention to a senior citizens group? (Select all that apply.) a. Do not smoke in bed or when sleepy. b. Wear well-fitted clothing when cooking or when grilling outdoors. c. Establish a meeting place for all family members outside of the home in case of a fire. d. Establish a plan for exiting each room of your home in the case of a fire. e. Have a fire extinguisher readily available in the kitchen.

Do not smoke in bed or when sleepy Wear well-fitted clothing when cooking or when grilling outdoors Have a fire extinguisher readily available in the kitchen

A nurse manager is providing a novice geriatric nurse with guidelines when encouraging an older client to reminisce about his or her life and past experiences. Which suggestions will be included? (Select all that apply.) a. Don't correct the client even when you suspect the memory is incorrect. b. When the focus remains on sad topics, assess the client for possible depression. c. Refrain from interjecting personal stories into the reminiscing process. d. Expect and respect a degree of repetition. e. Use close-ended questions to help focus the reminiscing.

Don't correct the client even when you suspect the memory is incorrect. When the focus remains on sad topics, assess the client for possible depression. Expect and respect a degree of repetition.

Which activity assures the nurse that the client's wish to "leave a living legacy" has been accomplished? a. Donating his body to the local teaching hospital for research purposes b. Discussing his experiences as a World War II veteran in Europe to a reporter c. Keeping a journal to be passed on to his great-grandchildren d. Making a pilgrimage to a location with personal religious significance

Donating his body to the local teaching hospital for research purposes

An older adult with suspected Parkinson's disease has a "challenge test" performed in order to confirm the diagnosis. The nurse understands that a "challenge test" will demonstrate which of the following? a. Immediate reversal of all symptoms of Parkinson's disease after administration of levodopa b. Dramatic improvement of symptoms of Parkinson's disease after administration of levodopa c. Dramatic improvement in gait only after administration of levodopa d. Dramatic improvement in tremor only after administration of levodopa

Dramatic improvement of symptoms of Parkinson's disease after administration of levodopa

A nurse is caring for an older adult with xerosis. Which of the following interventions should the nurse include in the patient's plan of care? (Select all that apply.) a. Encourage adequate fluid intake. b. Encourage daily baths of at least 20 minutes. c. Maintain a humid environment. d. Apply water-laden emulsions to skin immediately after bathing. e. Use only deodorant soaps when bathing. ANS: A, C, D

Encourage adequate fluid intake. Maintain a humid environment. Apply water-laden emulsions to skin immediately after bathing.

An older adult complains of xerostomia. Which of the following interventions should the nurse implement for this patient? (Select all that apply.) a. Encourage the patient to brush and floss teeth regularly. b. Encourage the patient to have regular dental screenings. c. Provide antiseptic mouthwash (e.g., Listerine) for the patient. d. Encourage adequate intake of water. e. Provide saliva substitutes.

Encourage the patient to brush and floss teeth regularly Encourage the patient to have regular dental screenings Encourage adequate intake of water Provide saliva substitutes

A nurse is assisting an older adult to cope with depression after the loss of a spouse. Which of the following actions should the nurse take? (Select all that apply.) a. Encourage the person to develop a daily activity schedule that includes pleasant activities. b. Validate depressed feelings as aiding recovery. c. Discourage angry outbursts. d. Suggest that the person not make any decisions until the depression has passed. e. Involve the family in teaching about depression.

Encourage the person to develop a daily activity schedule that includes pleasant activities Validate depressed feelings as aiding recovery Involve the family in teaching about depression

Which intervention is therapeutic when facilitating communication with a cognitively impaired older client? (Select all that apply.) a. Explain a task using simple, concise phrasing and one step at a time. b. Give instructions to a group whenever possible to provide peer support. c. Allow for additional time for the client to respond to questions or directions. d. Use nonverbal as well as verbal cues to help get your message across to the client. e. Speak loudly to gain and retain the client's attention.

Explain a task using simple, concise phrasing and one step at a time. Allow for additional time for the client to respond to questions or directions. Use nonverbal as well as verbal cues to help get your message across to the client.

Which intervention has priority before touching a client's consent zone? a. Draping the area to minimize exposure b. Having another nurse present c. Explaining why the area will be touched while asking permission d. Assuring the client that the touch is absolutely necessary

Explaining why the area will be touched while asking permission

A nurse at a senior center promotes activity by leading a yoga class. Which of the following is a benefit of such exercise? a. Facilitates range of motion. b. Strengthens the heart muscle. c. Decreases serum triglycerides. d. Prevents sarcopenia.

Facilitates range of motion

A nurse organizes a symposium for health care professionals in the field of geriatrics. Which of the following topics align with Healthy People 2020s emerging issues relevant to healthy aging? (Select all that apply.) a. Fair pay and compensation standards for informal caregivers b. Longevity and genetics c. Emerging chronic conditions among baby boomers d. Minimum competency levels for health care professionals e. Health disparities in LGBT older adults

Fair pay and compensation standards for informal caregivers Emerging chronic conditions among baby boomers Minimum competency levels for health care professionals Health disparities in LGBT older adults

Which intervention addresses a right guaranteed a long-term care facility resident? a. Ethnic foods are made available to culturally diverse residents who would like them. b. Each resident has access to a telephone in his or her room. c. Family members are welcome at any time. d. A professional hairdresser is available 3 days a week.

Family members are welcome at any time

An older woman tearfully tells a nurse, "I must buy my neighbor all of his groceries, or he will not drive me to the store or the doctor." This is an example of which type of elder mistreatment? a. Financial exploitation b. Psychological abuse c. Caregiver neglect d. Abandonment

Financial exploitation

The nurse is preparing educational material concerning fire safety in the home. What research data will be included in the material? a. Most fires occur during the daytime hours. b. Fire mortality is highest in adults older than 80 years of age. c. Most people who die in fires are killed by the flames. d. Most fires occur outside the home.

Fire mortality is highest in adults older than 80 years of age

A nurse is caring for a patient with a diagnosis of delirium. Which of the following is an expected assessment finding for this patient? a. Normal attention span b. Fluctuation in symptoms c. Normal sleep cycle d. Increased appetite

Fluctuation in symptoms

An older adult tells a nurse that he is experiencing difficulty falling asleep, he routinely gets into bed at 8:30 PM and watches his favorite television shows until 11:00 PM, and often lies awake for hours after. Which of the following suggestions are appropriate for the nurse to give to this patient? (Select all that apply.) a. Go to bed only when sleepy. b. If unable to sleep within a reasonable time (15-20 minutes), get out of bed and pursue relaxing activities. c. Engage in moderate exercise to induce fatigue. d. Do not watch television or work in bed. e. If unable to sleep, engage in enjoyable activities on the computer.

Go to bed only when sleepy If unable to sleep within a reasonable time (15-20 minutes), get out of bed and pursue relaxing activities Do not watch television or work in bed.

Which behavior is characteristic of grief by a disenfranchised adult child in response to a parent's death following a lengthy, painful illness? a. Crying out loudly while invoking "God's help" to go on with life b. Announcing to family members, "I've already grieved the loss" c. Having difficulty even deciding what to wear to the funeral d. Going on a drinking binge instead of attending the funeral

Going on a drinking binge instead of attending the funeral

Which behavior suggests that an older adult who has lost his life partner is successfully managing the exploration stage of the adjustment process? a. He enrolls in a cooking class. b. He explains that he can't make a decision about moving "just yet." c. He agrees to eat some of his "favorite soup" that his daughter has made. d. He is heard saying, "I'll never get over the loss, but my life has a purpose."

He enrolls in a cooking class.

A group of older women in an assisted living facility are talking about one of the residents who fell and fractured her hip. The women ask a nurse the following: "It seems like so many of us fall and break our hips, and then it is downhill from there. Is this really true?" In formulating a response, the nurse considers which of the following? (Select all that apply.) a. Hip fractures are a leading cause of hospitalization for older people. b. The major cause of hip fractures is falls. c. Women have significantly higher mortality rates from hip fractures than do men. d. Nearly all older patients who sustain a hip fracture will regain prefracture mobility status within 1 year. e. Hip fractures are associated with very high morbidity and mortality.

Hip fractures are a leading cause of hospitalization for older people. The major cause of hip fractures is falls. Hip fractures are associated with very high morbidity and mortality.

The daughter of an older patient says to a nurse, "I am so concerned that my dad is still driving. He is dangerous! He has had a couple of accidents and I am worried that he is going to kill himself or, worse, somebody else. What can I do?" The nurse recommends which of the following involved type action strategies for driving cessation? (Select all that apply.) a. Report the person to the division of motor vehicles for license suspension. b. Hold a family meeting with the person to discuss the situation and come to a mutual agreement of the problem. c. Arrange for alternate transportation for the person. d. Confiscate the keys to the car. e. Ask the patient's physician to write a prescription for the person to stop driving.

Hold a family meeting with the person to discuss the situation and come to a mutual agreement of the problem. Arrange for alternate transportation for the person.

Which statement regarding touch and touch zones is most accurate? a. People between the ages 66 and 100 are the most often touched. b. Newly graduated nurses tend to touch clients less often than do nursing students. c. When performing pericare, the nurse is working within the zone of intimacy. d. Illness, confinement, and dependency are stresses on the intimate zone of touch.

Illness, confinement, and dependency are stresses on the intimate zone of touch.

Which of the following nursing interventions should be implemented to prevent dehydration in hospitalized older adults? (Select all that apply.) a. Implementing intake and output recording for any patients with fever, diarrhea, vomiting, or an infection b. Limiting duration of NPO requirements for diagnostic tests and procedures c. Administering IV fluids to all hospitalized older adults d. Limiting the use of diuretic medications in hospitalized older adults e. Making sure that hospitalized patients have easy access to fluids

Implementing intake and output recording for any patients with fever, diarrhea, vomiting, or an infection Limiting duration of NPO requirements for diagnostic tests and procedures Making sure that hospitalized patients have easy access to fluids

The major goal of the NICHE (Nurses Improving Care for Health System Elders) program includes which of the following? a. Improve outcomes for hospitalized older adults. b. Increase the number of older adults cared for in hospitals. c. Increase the number of iatrogenic complications that occur in hospitalized older adults. d. Decrease 30-day readmission rates for hospitalized older adults.

Improve outcomes for hospitalized older adults

Which outcome regarding the effects of therapeutic touch on the skin is inaccurate? a. Brings about sensory stimulation. b. Helps relieve physical and psychosocial pain. c. Is known to reduce anxiety and tension. d. Improves skin integrity.

Improves skin integrity

Which of the following factors contribute to poor outcomes for older adults during transitions of care? (Select all that apply.) a. Inability to read and understand discharge instructions b. Inadequate financial resources to purchase medications c. Lack of desire to comply with discharge instructions d. Improved medication reconciliation during hospitalization e. High levels of nurse-patient engagement

Inability to read and understand discharge instructions Inadequate financial resources to purchase medications

. A nurse is preparing education for a group of older adults and caregivers at a senior center on elder abuse. The nurse is preparing to discuss seniors who are more likely to be abused or neglected. The nurse includes which of the following? (Select all that apply.) a. Individuals with cognitive impairment b. Individuals who abused the caregiver earlier in life c. Individuals who live in an institutional setting d. Individuals who are married and living with a spouse e. Men living alone or in a household with family members

Individuals with cognitive impairment Individuals who abused the caregiver earlier in life Individuals who live in an institutional setting

In a long-term care facility, a nurse is having a discussion with the nurse aides about ways to deal with dementia clients who are uncooperative with mouth care. Appropriate methods to use include: a. speaking to the client sternly and instructing the client to open the mouth and cooperate immediately. b. having another nurse aide assist in holding the client's mouth open with a tongue depressor. c. initiating the action with the expectation that the client will take over. d. quickly performing oral hygiene without explanation since the client is uncooperative.

Initiating the action with the expectation that the client will take over

Which statement best demonstrates the primary benefit of intergenerational partnering and the activities that it creates? a. These types of activities can help establish new relationships. b. Intergenerational activities can foster a sense of meaning and purpose. c. Such partnering can increase the self-esteem of the younger people. d. These activities can decrease social isolation in the older people.

Intergenerational activities can foster a sense of meaning and purpose.

The nurse managers of the geriatric and pediatric units arrange an intergenerational holiday party. The rationale for arranging such a partnering is based on which principle? (Select all that apply.) a. Intergenerational activities can help all participants establish new relationships. b. Intergenerational activities are required by state and local geriatric regulatory agencies. c. Intergenerational activities provide the units with an opportunity to improve interagency cooperation. d. Intergenerational activities are beneficial for older adults because they can decrease isolation and foster a sense of meaning and purpose. e. Intergenerational activities provide youngsters with an opportunity to interact with older adults.

Intergenerational activities can help all participants establish new relationships. Intergenerational activities are beneficial for older adults because they can decrease isolation and foster a sense of meaning and purpose. Intergenerational activities provide youngsters with an opportunity to interact with older adults.

When educating an older adult about Medicare Part D, which information will be included? (Select all that apply.) a. It is an elective prescription drug plan with associated out-of-pocket premiums. b. All persons with either Medicare Part A or B can voluntarily purchase a Medicare Part D prescription drug plan. c. The plan covers all costs of drugs after a deductible is paid. d. The plan is not available for individuals who are receiving both Medicaid and Medicare. e. This prescription drug plan requires client co-payments.

It is an elective prescription drug plan with associated out-of-pocket premiums All persons with either Medicare Part A or B can voluntarily purchase a Medicare Part D description drug plan. This prescription drug plan requires client co-payments

When an older adult is considering long-term care insurance (LTCI), what is important for the nurse to encourage the client to consider? a. The older one is when applying, the lower the rates will be. b. It is financially better to avoid purchasing LTCI through a group policy. c. It is wise to scrutinize all exclusions before enrolling. d. All policies cover care at home as well as in a long-term care facility.

It is wise to scrutinize all exclusions before enrolling

An older patient is prescribed warfarin for stroke prevention. A nurse is providing patient education. Which of the following foods should the patient be taught to avoid? (Select all that apply.) a. Milk b. Whole grains c. Kale d. Spinach e. Red meats

Kale and Spinach

Which attempt by the family to prevent an older, frail adult from falling causes the home health nurse concern? a. Keeping several low wattage night-lights on in the evening b. Installing wooden railings on the stairway to the bathroom c. Keeping the side rails up on the client's bed at night d. Encouraging the client to use a cane when ambulating

Keeping the side rails up on the client's bed at night

An elder is experiencing severe chronic pain resulting from a terminal illness. Which intervention by the nurse would be most appropriate when he verbalizes a desire to find "some sort of meaning to all of this"? a. Introduce a sensory distraction, such as television. b. Reassure him that this is normal phase that everyone experiences. c. Listen and help him express his feelings about life and death. d. Ask the doctor to order a psychiatric consult for possible depression.

Listen and help him express his feelings about life and death.

A home health nurse is making a home visit to an older patient. A nurse conducts a home safety assessment and screens the environment for potential hazards for falls. The nurse recommends that the patient eliminate which of the following? (Select all that apply.) a. Night-lights b. Railings on the stairway c. Loose carpeting on the floors d. The use of a cane e. Excess clutter

Loose carpeting on the floors Excess clutter

A nurse is performing an admission assessment on an older patient who presented with a high fever and cough, reduced oral intake for 3 days, and lower extremity weakness. The patient has sunken eyes, and the patient's skin turgor over the sternum is poor. The nurse suspects that the patient is dehydrated. Which of the following are indicators of dehydration in this patient? (Select all that apply.) a. Poor skin turgor over the sternum b. Lower extremity weakness c. High fever d. Sunken eyes e. Cough

Lower extremity weakness Sunken eyes

An older patient is concerned that her neighbor was recently diagnosed with Alzheimer's disease and asks a nurse what can be done to decrease the risk of Alzheimer's disease. The nurse includes which of the following in the response to the patient? (Select all that apply.) a. Maintain blood pressure within normal limits. b. Smoking cessation. c. Maintain control of blood sugar (hemoglobin A1C ≤7). d. Eliminate fats from the diet. e. Maintain healthy body weight.

Maintain blood pressure within normal limits. Smoking cessation. Maintain control of blood sugar (hemoglobin A1C ≤7). Maintain healthy body weight.

A nurse is caring for a frail older adult in a long-term care facility and is concerned about preventing hypothermia. Which of the following interventions should the nurse implement? (Select all that apply.) a. Make sure that the temperature in the resident's room is at least 68° F. b. Cover residents well when in bed and while bathing. c. Provide a head covering for the resident. d. Maintain resident in bed covered with heavy blankets at all times. e. Provide hot, high-protein meals and bedtime snacks.

Make sure that the temperature in the resident's room is at least 68° F. Cover residents well when in bed and while bathing. Provide a head covering for the resident. Provide hot, high-protein meals and bedtime snacks.

An older adult asks a nurse, "I saw an advertisement and went to a free breakfast to hear about Medicare Advantage Plans. They sound really good, but I am not sure. Are there benefits to joining one?" The nurse relies on which of the following information when formulating a response? (Select all that apply.) a. All Medicare Advantage Plans have prescription drug coverage. b. Medicare Advantage Plans must cover all services traditionally covered by Medicare Parts A and B. c. There are no deductibles in Medicare Advantage Plans. d. Medicare Advantage Plans may provide a cost savings to the member. e. Members must obtain a referral to see a specialist from an assigned primary care provider.

Medicare Advantage Plans must cover all services traditionally covered by Medicare Parts A and B. Medicare Advantage Plans may provide a cost savings to the member. Members must obtain a referral to see a specialist from an assigned primary care provider.

A 77-year-old client recently lost her husband to a chronic progressive neurological disease. She has a history of osteoarthritis and hypertension and was newly diagnosed with metastatic gastric cancer. She sold her home and moved to another state to be closer to her children, but she misses her many close friends. What makes her at risk for spiritual distress? (Select all that apply.) a. Metastatic cancer b. Age (77) c. Moving far away from other family and friends d. Loss of a spouse e. Chronic conditions: hypertension and arthritis

Metastatic cancer Moving far away from other family and friends Loss of a spouse

. Which of the following are subscales on the Braden Scale for predicting pressure ulcers? (Select all that apply.) a. Nutrition b. Moisture c. Mobility d. Age e. BMI

Nutrition Moisture Mobility

Which nursing intervention best addresses the need for social support demonstrated by an older adult couple who will be assuming responsibility for the raising of two grandchildren? a. Facilitating a support group for children being raised by grandparents b. Helping the grandparents express their feeling regarding this unexpected role change c. Offering a monthly parenting class for this cohort of grandparents d. Suggesting couple's therapy to assist in managing any new stress on their marriage

Offering a monthly parenting class for this cohort of grandparents

A homecare nurse in an area of the country that is prone to tornadoes routinely discusses disaster preparedness with older adult clients. What is the primary rationale for this intervention? a. Older adults are less likely to seek formal and informal help when affected by natural disasters. b. The older adult is more likely to live in a communal environment that provides assistance in times of natural disasters. c. Most older adults have insurance to help them recover from material losses due to a natural disaster. d. Federal and private assistance agencies generally provide older adults with priority attention in time of natural disasters.

Older adults are less likely to seek formal and informal help when affected by natural disasters

A "good coper" is more likely to have which characteristic? a. History of mental illness. b. Expectations of perfection c. Optimistic outlook d. Demanding of others

Optimistic outlook

When acting as a fictive kin, in which activity will a paid caregiver engage? a. Being responsible for paying the client's bills b. Organizing the client's birthday celebration c. Accompanying the client to doctor's appointments d. Assuring the client has clean, appropriate clothing available

Organizing the client's birthday celebration

A nurse is caring for a patient in Portland, Oregon, who has a terminal illness. The patient tells the nurse that she has made a decision to try palliative sedation. The nurse knows that palliative sedation includes which of the following? (Select all that apply.) a. Pharmacological relief of refractory symptoms will be achieved by whatever means necessary. b. The intent of palliative sedation is to relieve refractory symptoms as long as death isn't hastened. c. Palliative sedation is legal in all 50 states. d. The goal of palliative sedation is to relive suffering with treatment. e. If palliative sedation hastens death, it is considered assisted suicide.

Pharmacological relief of refractory symptoms will be achieved by whatever means necessary. Palliative sedation is legal in all 50 states. The goal of palliative sedation is to relive suffering with treatment.

Two older residents of a long-term care facility are engaged in a romantic relationship. The residents are both cognitively intact. A nurse finds the two residents engaging in sexual activity. The response of the nurse includes which of the following? (Select all that apply.) a. Inform the residents that they cannot engage in a sexual relationship while they are residents of the facility. b. Provide a safe private area where the residents can engage in sexual activity. c. Ignore the residents' activity. d. Provide education for the residents using the PLISSIT model. e. Contact the family members of the residents in order to get consent from them.

Provide a safe private area where the residents can engage in sexual activity. Provide education for the residents using the PLISSIT model.

Best practice recommendations for nursing education in relation to gerontology include which of the following? (Select all that apply.) a. Provision of a "stand-alone" course in gerontological nursing b. Integration of gerontological content throughout the curriculum c. Replacement of acute care pediatric clinical experiences with gerontological clinical experiences d. Recruitment of nurses with Masters and Doctoral degrees and a specialty in gerontology to faculty roles e. Requiring all undergraduate nursing students to obtain gerontological certification as a requirement for graduation

Provision of a "stand-alone" course in gerontological nursing Integration of gerontological content throughout the curriculum Recruitment of nurses with Masters and Doctoral degrees and a specialty in gerontology to faculty roles

The impact of the Hospital Readmission Reduction Program (HRRP) on avoidable readmissions includes which of the following? (Select all that apply.) a. Readmission rates for the selected conditions have dropped nationwide. b. Many hospitals have instituted system-wide interventions to prevent readmissions. c. Hospitals are keeping patients longer to avoid readmissions. d. Potentially avoidable hospitalizations among nursing home residents is increasing. e. Hospitals have a financial incentive to develop programs to reduce readmissions.

Readmission rates for the selected conditions have dropped nationwide. Many hospitals have instituted system-wide interventions to prevent readmissions. Hospitals have a financial incentive to develop programs to reduce readmissions.

Which of the following reactions to the loss of a spouse or long-term partner is a unique example of older adult male bereavement? a. Withdrawing from friends and family b. Remarrying within months of the loss c. Focusing on "doing" rather than "feeling" d. Experiencing moderate to severe depression

Remarrying within months of the loss

The nurse is caring for an older client who experienced a hip replacement surgery 10 hours ago. Which intervention will help minimize this client's risk of developing delirium? a. Requesting that staff offer fluids each time they interact with the client b. Medicating the client to best facilitate restorative sleep c. Encouraging the client to remain still and thus minimize pain d. Suggesting that visitors are limited to family members only

Requesting that staff offer fluids each time they interact with the client

Which nursing evaluation supports the fact that the goals of long-term client care have been achieved? Select all that apply. a. Resident has participated in bath with minimal assistance from the staff. b. Resident has experienced no falls since admission 3 months ago. c. Resident continues to show loss of strength in upper extremities. d. Resident is not required to dress or feed self since assistance is always available. e. Resident demonstrates improved weight bearing on affected leg; discharge to be considered.

Resident has participated in bath with minimal assistance from the staff. Resident has experienced no falls since admission 3 months ago. Resident demonstrates improved weight bearing on affected leg; discharge to be considered.

A diagnosis of Parkinson's disease is made based on the presence of which of the following symptoms? (Select all that apply.) a. Rigidity b. Resting tremor c. Bradykinesia d. Orthostatic hypotension e. Progressive decline in cognitive function

Rigidity Resting tremor Bradykinesia

Which technique is most effective when communicating with a client who is positioned in bed? a. Sitting in a chair at the foot of the bed b. Standing near the client's head on his or her dominant side c. Sitting in a chair at the bedside facing the client d. Standing at the foot of the bed

Sitting in a chair at the bedside facing the client

A patient tells the nurse, "Every time I laugh or cough, I wet myself." Which type of urinary incontinence is this patient describing? a. Urge b. Functional c. Stress d. Mixed

Stress

Differences between subacute care and long-term care include which of the following? (Select all that apply.) a. Subacute care is more costly than long-term care. b. Higher levels of professional staffing are generally found in subacute settings. c. Medicare covers the costs of both subacute and long-term care. d. Subacute patients tend to be younger and more cognitively intact. e. Subacute care is usually delivered in a hospital setting and long-term care in a nursing home setting.

Subacute care is more costly than long-term care. Higher levels of professional staffing are generally found in subacute settings. Subacute patients tend to be younger and more cognitively intact.

A nurse is developing a care plan for an older adult in a long-term care facility that has a nutritional problem. Which of the following interventions are appropriate to ensure adequate nutrition? (Select all that apply.) a. Assign a nursing aide to feed the resident to ensure adequate consumption of meals. b. Supervise the resident during meals. c. Provide a pleasant eating environment. d. Provide nutritional supplements for the resident. e. Assess the resident for ability to feed himself or herself.

Supervise the resident during meals. Provide a pleasant eating environment. Provide nutritional supplements for the resident. Assess the resident for ability to feed himself or herself.

A woman is terminally ill. Although it has never been discussed in the family or stated outright by her physician, she is growing to believe that she will die because of her illness. Upon which concept will the nurse base therapeutic intervention on? a. Closed awareness b. Suspected awareness c. Mutual pretense d. Open awareness

Suspected awareness

A long-term care facility has selected sleep promotion as its quality improvement project. Which of the following interventions would be appropriate to implement on this unit? (Select all that apply.) a. Ensuring that all residents receive evening care and are in bed by 8:00 PM b. Taking as many residents as possible outside for 30 minutes daily c. Instituting quiet time (keep noise down, speak in hushed tones, no overhead paging) between 9:00 PM and 6:00 AM d. Avoiding waking residents for routine care during the night e. Limiting caffeine and fluids before bedtime

Taking as many residents as possible outside for 30 minutes daily Instituting quiet time (keep noise down, speak in hushed tones, no overhead paging) between 9:00 PM and 6:00 AM Avoiding waking residents for routine care during the night Limiting caffeine and fluids before bedtime

When comparing the Older American's Resources and Services (OARS) with the Katz Index of ADLs, what is true? a. The Katz Index and the OARS both measure only ADL performance. b. The OARS is a comprehensive assessment tool that measures ability in five areas; the Katz Index measures only ADL performance. c. The OARS is used only for older adults in the long-term care setting; the Katz Index is used in all settings. d. The OARS is not valid for use in older adults who are cognitively impaired, whereas the Katz Index is.

The OARS is a comprehensive assessment tool that measures ability in five areas; the Katz Index measures only ADL performance.

A home health nurse is making a home visit to an older patient. A nurse conducts a home safety assessment and screens the environment for potential hazards for falls. Which of the following are hazards in the home? (Select all that apply.) a. The absence of railings on the stairway b. Night-lights in all rooms c. Clutter throughout the home d. A small throw rug outside of the shower stall e. Grab bars in bathroom beside toilet

The absence of railings on the stairway Clutter throughout the home A small throw rug outside of the shower stall

A homecare nurse visits a client in the home to conduct a fall risk assessment. The nurse assesses the client and the home for extrinsic risk factors for falls. Which of the following are extrinsic risk factors? (Select all that apply.) a. The client has an unsteady gait. b. The client uses a cane, but the cane is not the appropriate size for the client. c. The client's home is cluttered. d. The client is on two different medications that cause orthostatic hypotension. e. There are no grab bars in the client's bathroom.

The client uses a cane, but the cane is not the appropriate size for the client. The client's home is cluttered. There are no grab bars in the client's bathroom.

The nurse sits at the bedside of a comatose, terminally ill older client reading the wishes expressed in the numerous cards the client has received. Which concept of grief work is the nurse addressing with this intervention? a. Everyone needs social interaction. b. The nurse needs to "attend to the patient." c. Hearing is believed to be the last sense to be lost. d. The individual is living until he or she is dead.

The individual is living until he or she is dead.

A nurse is observing a nurse aide perform denture care for a resident in the nursing home. The nurse recommends that the nurse aide receive additional education on denture care when the nurse observes which of the following? a. The nurse aide places a face cloth in the sink and fills the sink half full with water. b. The nurse aide uses toothpaste to clean the dentures. c. The nurse aide utilizes a specially designed denture brush to clean the dentures. d. The nurse aide stores the dentures in a denture cup filled with denture cleansing solution.

The nurse aide uses toothpaste to clean the dentures

Which of the following are true statements about the current health care workforce? (Select all that apply.) a. Approximately 10% of registered nurses (RNs) are certified in gerontological nursing. b. The number of geriatricians is expected to increase about 50% over the next 25 years. c. The professions of social work, physical therapy, and psychiatry are demonstrating the same trends as nursing. d. Europe and the developing countries are experiencing similar shortages in health care workers with geriatric expertise as in the United States. e. It is anticipated that there will be a need for approximately 3.5 million additional direct care and professional health care workers by the year 2030.

The professions of social work, physical therapy, and psychiatry are demonstrating the same trends as nursing. Europe and the developing countries are experiencing similar shortages in health care workers with geriatric expertise as in the United States. It is anticipated that there will be a need for approximately 3.5 million additional direct care and professional health care workers by the year 2030.

A nurse is caring for an older adult in a hospital who has an indwelling catheter. The nurse assesses the patient based on the knowledge that which of the following are correct indications for an indwelling catheter? (Select all that apply.) a. To assist with incontinence management b. To manage acute urinary retention c. To assist in healing of open sacral or perineal wounds in incontinent patients d. To accurately measure urinary output in critically ill patients e. To prevent falls related to toileting in hospitalized older patients

To manage acute urinary retention To assist in healing of open sacral or perineal wounds in incontinent patients To accurately measure urinary output in critically ill patients

The nurse is aware inflamm-aging most likely explains why the older population is at risk for autoimmune disorder. What common strategy has been found to have deleterious effects on immunity? a. Judicious use of herbal supplements b. Regular exercise c. Annual influenza vaccination d. Use of supplemental antioxidants

Use of supplemental antioxidants

An older adult who has a balance disorder and has sustained repeated falls is recommended to start an exercise program. Which of the following exercises would be most beneficial in improving balance in this individual? (Select all that apply.) a. Yoga b. Tai Chi c. Swimming d. Pilates e. Weight lifting

Yoga Tai Chi

A nurse is providing an educational session on vaccines to a group of older adults. The nurse is discussing the zoster vaccine (Zostavax). Which of the following information should the nurse include in the education? a. Zostavax should only be given to individuals who have never had an episode of herpes zoster (HZ). b. Zostavax is recommended for all individuals over age 60 that have no contraindications to the vaccine. c. Zostavax should not be given to anyone with a chronic cardiac or respiratory condition. d. Zostavax will always prevent an individual from developing Herpes Zoster.

Zostavax is recommended for all individuals over age 60 that have no contraindications to the vaccine.

A nurse administers the Short Michigan Alcohol Screening Test Geriatric Version (S-MAST-G) to an older adult. The older adult receives a score of "2." The nurse knows that this score is indicative of: a. no problem with alcohol. b. a problem with alcohol. c. a mild problem with alcohol. d. a severe problem with alcohol.

a problem with alcohol

The nurse is most concerned by observing when assisting with an older client's bath: a. a firm, irregularly shaped, pink-colored nodule. b. a slightly raised multicolor lesion with an asymmetrical, irregular border. c. a pearly papule with prominent blood vessels. d. rough, scaly, sandpaper-like patches that are slightly tender.

a slightly raised multicolor lesion with an asymmetrical, irregular border

The nurse preparing educational information on the most common mental health disorder among the older adult population should include: a. methods for reducing anxiety. b. a written depression screening tool. c. local schizophrenia support groups. d. signs and symptoms of alcoholism.

a written depression screening tool

Factors that are influencing the decrease in nursing home beds in the United States include: (Select all that apply.) a. an increase in the use of residential care facilities. b. a shortage of certified nursing assistants (CNAs). c. increased Medicaid reimbursement for community-based care alternatives. d. a shortage of registered nurses who are certified in gerontology. e. the high cost of care in a nursing home.

an increase in the use of residential care facilities. increased Medicaid reimbursement for community-based care alternatives.

An otherwise healthy older adult reports having begun to experience problems "holding my water." The nurse shows an understanding of interventions that may help minimize the problem of urinary incontinency when: (Select all that apply.) a. asking whether the client smokes tobacco. b. assessing the average amount of caffeine the client drinks daily. c. asking if the client has been evaluated for diabetes recently. d. suggesting the client keep a record of the amount of fluids ingested daily. e. reviewing the client's current medication list.

asking whether the client smokes tobacco. assessing the average amount of caffeine the client drinks daily. asking if the client has been evaluated for diabetes recently. reviewing the client's current medication list.

When caring for an ill adult client, the nurse is particularly concerned that the client communicates well since: (Select all that apply.) a. assessment, planning of care, and even the therapeutic relationship is based on effective communication. b. it is the social connection that all individuals base interpersonal relationships upon. c. how well an individual communicates is a reflection on both his or her physical and emotional well-being. d. the need to communicate is a basic need of all individuals.

assessment, planning of care, and even the therapeutic relationship is based on effective communication. it is the social connection that all individuals base interpersonal relationships upon. the need to communicate is a basic need of all individuals.

An older resident in a long-term care facility reports to the nurse that she has been noticing changes in her vision, including the appearance of halos around objects and a yellow tint to most objects. The nurse knows that these complaints are most often associated with: a. cataracts. b. glaucoma. c. diabetic retinopathy. d. age-related macular degeneration.

cataracts

A female nurse is caring for an older woman from the Hasidic Jewish community. The woman's son is at the patient's bedside. The nurse notes that when she communicates with the patient and her son, the son does not maintain eye contact with her and also notes that he withdraws when she attempts to shake his hand. The best response by the nurse is to: a. carry on conversation with the patient only, ignoring the son. b. continue conversing with both the patient and the son. c. ask the son to leave since he is not comfortable with her. d. ask the patient why the son will not engage with her.

continue conversing with both the patient and the son

The nurse implements the concepts of the activity theory of aging when instructing the older client with osteoarthritis to: a. continue her daily walking routine. b. curtail further increases in physical activity. c. document preferred end-of-life interventions. d. avoid exposing herself to crowds.

continue her daily walking routine

A married couple retired to a life care community after the husband had heart surgery. The wife has always been physically and socially active and joined an aerobic class, knitting groups, and a book club shortly after moving to the community. She walks on a daily basis and swims twice a week. Her husband spends his days reading and watching television. He was never a social person and enjoys being by himself. Which of the sociological theories of aging best describes the couple? a. Role theory b. Disengagement theory c. Continuity theory d. Personality theory

continuity theory

When the daughter of a client diagnosed with moderate Alzheimer's disease (AD) asks about the possible benefits of enrolling her mother in art classes, the nurse's response is based on the knowledge that: a. creative activities are not limited to cognitively intact older adults; even individuals with dementia can benefit from creative activities. b. individuals with dementia who have rational language skills can benefit from creative activities. c. cognitively impaired elders cannot benefit from creative activities due to altered brain processes. d. cognitively impaired elders are usually too agitated to participate in creative arts.

creative activities are not limited to cognitively intact older adults; even individuals with dementia can benefit from creative activities.

An older adult has recently experienced a number of stressful life events. The client comes to the ambulatory clinic and tells the nurse that, "On top of all I've had to endure, now I've got this flu!" In rendering care for this client, the nurse recognizes that: a. the client is exhibiting attention-seeking behaviors to substitute for poor coping skills. b. crisis and stressful situations may produce emotions that erode the health of the older people. c. the client is exhibiting learned helplessness as a result of the recent stressors. d. a period of crisis will ultimately lead to a lower level of physical and mental functioning.

crisis and stressful situations may produce emotions that erode the health of the older people

Which of the following are age-related changes that affect hydration status? (Select all that apply.) a. Decrease in thirst sensation b. Decrease in total body water c. Decrease in ability of kidneys to maximally concentrate urine d. Decrease in bone marrow mass e. Decrease in bladder capacity

decrease in thirst sensation decrease in total body water decrease in ability of kidneys to maximally concentrate urine

The nurse suspects that the spouse of a terminally ill client is experiencing anticipatory grief when he: a. dramatically reduces the time he spends attending to the client. b. refuses to leave the client's bedside regardless of the reason. c. sobs inconsolably whenever he visits. d. spends hours recalling details of their life together.

dramatically reduces the time he spends attending to the client

The greatest risk for injury for a client with progressed Parkinson's disease is: a. falls. b. suicide. c. bleeding ulcers. d. respiratory arrest.

falls

The nurse interviewing an older adult for a nursing history recognizes that the client is experiencing symptomology inconsistent with normal aging of the urinary tract when the client reports: (Select all that apply.) a. finding it more difficult in the last few months to start voiding. b. having two bladder infections in the last 4 years. c. getting up once or twice each night to urinate. d. occasionally experiencing pain when urinating. e. needing to urinate at least every 2 hours during the day.

finding it more difficult in the last few months to start voiding occasionally experiencing pain when urinating

When working with a bereaved individual, the goal of nursing interventions is to: a. assist the individual to go through the stages of grief work in the optimal order. b. foster the griever's movement from disequilibrium and instability to a new steady state. c. encourage the individual to talk about his or her feelings about the deceased individual. d. offer support and advice about how to successfully achieve grief work.

foster the griever's movement from disequilibrium and instability to a new steady state.

Factors that affect the pharmacokinetics of lipophilic medications in older adults include: a. greater adipose tissue ratio to body mass. b. decreased total body water. c. increased glomerular filtration rate. d. increased creatinine clearance.

greater adipose tissue ratio to body mass

The nurse is recommending that a client diagnosed with moderate stage Alzheimer's disease attend a support group when he becomes defensive about not driving his automobile and the effects it will have on "being stuck at home." Which is the priority outcome expected for this client when attending the group sessions? a. Facilitates socialization thus minimizing the effects of social isolation. b. Helps with minimizing the loss as a factor in causing depression. c. Provides caregivers with respite while assuring the client is well attended to. d. Allows for the opportunity for a mental health professional to assess the client. ANS: B

helps with minimizing the loss as a factor in causing depression

An older client admitted to the hospital after having sustained a fall at home is diagnosed with a right hip fracture and experienced a surgical reduction of the fracture. At 2:30 AM, she awakens from sleep insisting that her daughter is in the other room and wants to see her. Attempts to reorient her to the surroundings are unsuccessful. In reviewing the client's record, what data would be considered a primary risk factor for the delirium? a. History of dementia b. Death of the client's husband last month c. The client's age d. History of cardiac disease

history of dementia

The original intent of Social Security was to: a. provide a hospital insurance plan. b. minimize the dependency of older members on younger members of society. c. provide the blind, older adult, or disabled with adequate financial support. d. penalize women financially for numerous zero wage years while raising children.

minimize the dependency of older members of society

A nurse completes a functional status assessment of an older person using the Lawton IADL instrument, a self-reported instrument. The nurse knows that limitations of self-reported measures include that: (Select all that apply.) a. individuals tend to overestimate their functional ability. b. self-reports often differ from that of proxy reports. c. self-reports are not indicative of small changes in function. d. self-reports do not provide a valid measurement of function. e. older adults are not able to complete self-reported measurements.

individuals tend to overestimate their functional ability. self-reports often differ from that of proxy reports.

Differences in the presentation of patients with Alzheimer's disease (AD) and Dementia with Lewy bodies (DLB) are: (Select all that apply.) a. individuals with LB develop motor symptoms, and individuals with AD do not. b. individuals with AD display impairments in judgment whereas individuals with LB do not. c. the use of traditional atypical medication is contraindicated for individuals with LB. d. LB usually occurs in individuals under age 60, and AD occurs in individuals only over age 60. e. individuals with LB develop language symptoms, and individuals with AD do not.

individuals with LB develop motor symptoms, and individuals with AD do not. the use of traditional atypical medication is contraindicated for individuals with LB.

An older adult's diagnosis of sleep apnea is supported by nursing assessment and history data that include: (Select all that apply.) a. followed a vegetarian diet for last 28 years. b. male gender. c. a smoking history of 1 pack a day for 45 years. d. 30 pounds over ideal weight. e. history of Crohn's disease.

male gender a smoking history of 1 pack a day for 45 years 30 pounds over ideal weight

Symptoms of HIV are often under-recognized in older adults because: a. there is a very low incidence of HIV in older adults. b. many of the classic symptoms are also common to other conditions common in older adults. c. presenting symptoms are markedly different from those in younger adults. d. AIDS progresses much slower in older adults so symptoms are not recognized easily.

many of the classic symptoms are also common to other conditions common in older adults

A homecare nurse visits an older patient who lives in a Naturally Occurring Retirement Community (NORC). The nurse understands that NORCs are: a. purpose-built senior housing communities. b. neighborhoods or buildings where a large segment of the residents are older adults. c. communities where volunteers coordinate access to services for older adults. d. intentional collaborative housing where residents participate in the design and operation of the neighborhood.

neighborhoods or buildings where a large segment of the residents are older adults

An older adult says to the nurse, "I don't know why I can't handle booze like I used to when I was younger." The nurse's response is based on the knowledge that: a. older adults develop higher blood alcohol levels due to age-related changes in the neurological system. b. older adults develop higher blood alcohol levels due to age-related changes that alter absorption and distribution of alcohol. c. older adults develop higher blood alcohol levels due to slowed reaction times. d. older adults develop higher blood alcohol levels due to cognitive changes.

older adults develop higher blood alcohol levels due to age-related changes that alter absorption and distribution of alcohol.

An 88-year-old woman is admitted to the hospital with a diagnosis of pneumonia. She has a history of hypertension and congestive heart failure and is on a total of five different medications for these chronic conditions. The nurse caring for the woman develops a care plan that includes the diagnosis Risk for Falls. A priority nursing intervention for this client is to: a. perform a fall assessment. b. keep all of the side rails up on the client's bed at nighttime. c. place the client on bed rest so that she does not fall. d. assess the client's dietary intake for calcium adequacy.

perform a fall assessment

A nurse in a long-term care facility notes that there has been an increase in falls on one unit and that many of the falls are occurring immediately following mealtime. The nurse recommends that the nursing home conduct a trial of six smaller meals instead of the three traditional meals. The nurse makes this recommendation on the understanding that: a. postural changes in blood pressure are common in older adults and frequently occur around mealtimes. b. postprandial hypotension occurs after ingestion of a carbohydrate meal and may be related to the release of a vasodilatory peptide. c. residents of long-term care facilities are often on many different medications, which are given at mealtimes. d. it is common practice to take long-term care residents to the bathroom immediately following meals.

postprandial hypotension occurs after ingestion of a carbohydrate meal and may be related to the release of a vasodilatory peptide

The benefits of telehealth include that it: (Select all that apply.) a. promotes self-management of illness in rural and underserved areas. b. facilitates remote physical assessment and monitoring of chronic conditions. c. decreases costs by replacing the role of the nurse with technology. d. decreases costs by reducing hospital readmissions. e. is reimbursed by all health care insurances.

promotes self-management of illness in rural and underserved areas. facilitates remote physical assessment and monitoring of chronic conditions. decreases costs by reducing hospital readmissions.

A nurse is discharging an older patient after a hospitalization for a hip fracture. The patient is a participant in a Program for All Inclusive Care for the Elderly (PACE). The nurse understands that a PACE program: (Select all that apply.) a. provides services to older people who would otherwise need a nursing home level of care. b. does not provide services to participants who reside in a nursing home. c. is only available to individuals who have both Medicare and Medicaid. d. provides medications, eyeglasses, and transportation to care. e. provides urgent and preventive care.

provides services to older people who would otherwise need a nursing home level of care. provides medications, eyeglasses, and transportation to care. provides urgent and preventive care.

An older patient tells a nurse. "The nurse practitioner told me that these ugly purple bruises on my arms are called purpura and are due to fragile blood vessels. I still don't understand why this happens to me." The nurse responds based on the knowledge that: (Select all that apply.) a. purpura is due to normal age-related changes. b. the incidence of purpura increases with age. c. purpura is a precancerous skin condition. d. individuals who take blood thinners are especially prone to purpura. e. individuals prone to purpura should make sure that affected areas are open to the air.

purpura is due to normal age-related changes. the incidence of purpura increases with age. individuals who take blood thinners are especially prone to purpura.

A nurse caring for a cognitively impaired older adult client shows an understanding of the unique clinical symptoms of constipation in this population when: (Select all that apply.) a. checking documentation to determine if the client has had a bowel movement in the last 24-36 hours. b. questioning staff as to whether the client has any unexplained falls in the last few days. c. asking the client to name all of his or her children and grandchildren. d. requesting that the client's temperature be taken now and again in 4 hours. e. reviewing the client's food intake over the last 24-36 hours.

questioning staff as to whether the client has any unexplained falls in the last few days asking the client to name all of his or her children and grandchildren requesting that the client's temperature be taken now and again in 4 hours reviewing the client's food intake over the last 24-36 hours

Significant factors contributing to the growth of community-based care include: (Select all that apply.) a. a decrease in the number of available nursing home beds. b. rapidly escalating health care costs. c. older adults' preferences to "age in place." d. inadequate numbers of nurses with gerontological specialty education. e. decreasing numbers of family caregivers.

rapidly escalating health care costs. older adults' preferences to "age in place."

When an older adult reports experiencing several different stressors over the last 6 months, the nurse demonstrates an understanding of the physiological effects of stress on the body by: (Select all that apply). a. assessing the client using the Geriatric Depression Scale (GDS). b. testing the client's urine for red blood cells. c. screening the client for abnormally high serum glucose levels. d. inquiring as to whether the client has experienced weight changes.

screening the client for abnormally high serum glucose levels. inquiring as to whether the client has experienced weight changes.

A nurse is discussing the importance of exercise with a 78-year-old female who states: "I know I should be exercising, but I have arthritis in my knees and it is painful. Can you recommend a type of exercise that would be beneficial and cause me less pain?" Which of the following exercises should the nurse recommend? a. Tennis b. Swimming c. Dancing d. Use of a treadmill and elliptical machine in the gym

swimming

Health literacy is defined as: a. the capacity to read basic health information in order to make appropriate health decisions. b. the capacity to obtain, process, and understand basic health information needed to make appropriate health decisions. c. the capacity to read and write in order to access health care. d. the capacity to read and execute health care documents.

the capacity to obtain, process, and understand basic health

When assessing an older client for indications of depression, the nurse bases the intervention on the knowledge that: a. the older client's symptoms may be atypical for the disorder. b. depression is a common mental disorder among the older population. c. the older client is generally willing to discuss his or her mental health symptoms. d. depression is not as commonly seen in this population as are anxiety disorders.

the older client's symptoms may be atypical for the disorder

One reason why many baby boomers have multiple chronic conditions such as heart disease, diabetes, and arthritis is that: a. they have less access to medication and other treatment regimens b. there was a lack of importance placed on healthy living as they were growing up c. they did not have access to immunization against communicable disease when they were children d.they grew up in an era of rampant poverty and malnutrition

there was a lack of importance placed on healthy living as they were growing up

An older married couple is considering selling their home and moving into a continuing care retirement community (CCRC). The major benefit of a CCRC is: a. they provide affordable living for older adults. b. they have all levels of care in one location, allowing community members to easily transition between levels. c. they are paid for by Medicare. d. they allow the older adult's family to retain ownership of the property after the owner dies.

they have all levels of care in one location, allowing community members to easily transition between levels

A nurse administers hypodermoclysis (HDC) to an older nursing home resident. The purpose of hypodermoclysis is: a. to rehydrate an individual with severe dehydration. b. to quickly administer 4-5 L of fluid within a 24-hour period. c. to rehydrate an individual with mild to moderate dehydration. d. as a supplement to IV hydration to expedite rehydration.

to rehydrate an individual with mild to moderate dehydration

An older patient asks a nurse, "It seems like all of my friends and I have difficulty sleeping. Is it common among older people?" The nurse formulates a response based on the knowledge that normal age-related changes in sleep include: (Select all that apply.) a. total sleep time and sleep efficiency are reduced. b. rapid eye movement (REM) sleep is shorter, less intense, and more evenly distributed. c. sleep requirements for older adults are less than that of younger adults. d. daytime napping is common. e. sleep tends to be deeper in older adults than in younger adults.

total sleep time and sleep efficiency are reduced. rapid eye movement (REM) sleep is shorter, less intense, and more evenly distributed. daytime napping is common.

In order to focus on the older population with the greatest risk for suicide, the nurse would conduct a depression screening that targets: a. African American men. b. white men. c. white women. d. African American women.

white men

A 77-year-old client being treated for angle-closure glaucoma asks the nurse what caused his glaucoma. The nurse's response is: a. the angle of the iris causes obstruction of fluid in the eye. b. spasms of the orbicular muscle. c. changes to the suspensory ligaments, ciliary muscles, and parasympathetic nerves. d. bits of broken coalesced vitreous from the peripheral or central part of the retina.

the angle of the iris causes obstruction of fluid in the eye

The nurse suspects that a client is experiencing tardive dyskinesia when observing that: a. the client can't seem to stop moving. b. the client's facial muscles are twisting involuntarily. c. the client not able to get up out of a chair. d. the client's hand tremors so much that drinking from a cup is difficult.

the client's facial muscles are twisting involuntarily

An older man tells a nurse, "The doctor says I have something wrong with my eyes, something called presbyopia. Can you explain why I have this? I was always fortunate to have good eyesight." The nurse formulates a response based on the knowledge that: a. the lens of the eye loses elasticity causing a loss of focus for near objects. b. the cornea of the eye becomes thicker and less curved causing an increase in astigmatism. c. the lens of the eye increases in opacity causing a decrease in light refraction. d. the cornea of the eye forms a gray ring at the edges.

the lens of the eye loses elasticity causing a loss of focus for near objects

A nurse is assessing a patient's activities of daily living. The nurse will assess which of the following? (Select all that apply.) a. Eating b. Continence c. Toileting d. Self-medication administration e. Bathing

eating continence toileting bathing

A nurse is providing glaucoma education for a group of older adults in a senior center. The nurse knows that the following groups are most likely to develop glaucoma: (Select all that apply.) a. African Americans b. Mexican Americans c. Individuals with a family history of glaucoma d. Individuals with diabetes e. Asian Americans

African Americans Mexican Americans Individuals with a family history of glaucoma Individuals with diabetes

Changes in certified nursing facilities in recent years include which of the following? (Select all that apply.) a. Increase in the number of subacute beds b. Decrease in nursing facility length of stay c. Increase in level of acuity of the residents d. Decrease in cost of care in the nursing facility e. Decrease in the number of registered nurses employed in long-term care facilities

Increase in the number of subacute beds Decrease in nursing facility length of stay Increase in level of acuity of the residents

A nurse is conducting an assessment of an older patient's eyes. The nurse expects to see which of the following normal age-related changes of the external eye? a. The eyelids are less elastic and droopy. b. The eyes are very dry. c. The eyelids may not close completely. d. There is a loss of eyelashes. e. The lower lid may be turned outward.

The eyelids are less elastic and droopy. The eyes are very dry. The eyelids may not close completely. The lower lid may be turned outward.

The FANCAPES assessment tool focuses on the older adult's: a. ability to meet personal needs to identify the amount of assistance needed. b. ability to perform instrumental activities of daily living (IADLs). c. cognitive abilities. d. level of dementia present.

ability to meet personal needs to identify the amount of assistance needed

A 66-year-old retired professional basketball player is admitted to the hospital for a total knee replacement due to osteoarthritis. In discussing discharge planning for this patient, the nurse includes which theory of aging to help him understand the importance of early and ongoing exercise postoperatively? a. Role theory b. Activity theory c. Socioemotional selectivity theory d. Cross-link theory

activity theory

When discussing pharmacological considerations, a 68-year-old client asks, "Why do medications seem to act differently than they did when I was younger?" The nurse bases the response on the concept that: a. age-related changes affect the way drugs are metabolized by older adults. b. Over-the-counter (OTC) drugs have standardized dosages that are appropriate for all ages. c. older adults may need larger doses of medication to bring about the desired effects. d. adverse drug reactions occur with similar frequency in older adults as the general population.

age-related changes affect the way drugs are metabolized by older adults

An older patient reports the following symptoms to a nurse during a routine visit to the geriatric clinic: blurry vision, the need for more light when reading, and blind spots in the middle of his visual field. He also states, "Strangely enough my peripheral vision continues to be pretty good." The nurse suspects that the patient has which of the following? a. Glaucoma b. Age-related macular degeneration c. Diabetic retinopathy d. Cataracts

age-related macular degeneration

A limitation of the Katz Index of activities of daily living (ADLs) is that: a. completion of the tool requires the joint efforts of the interdisciplinary team. b. all ADLs are weighted equally. c. it puts a heavier weight on the cognitive abilities necessary to perform ADLs. d. it provides a range of performance for each task.

all ADLs are weighted equally

A hospitalized older adult who recently had surgery and a wound infection postoperatively is noted to be losing weight despite consuming his meal trays and snacks. One reason that this might be occurring is: a. an injury may trigger inflammatory mediators that increase metabolic rate and impair nutrient utilization. b. an injury may cause malabsorption of nutrients. c. most hospitalized older patients do not consume adequate amounts of micro- and macronutrients. d. most hospitalized patients do not have accurate weights recorded upon admission.

an injury may trigger inflammatory mediators that increase metabolic rate and impair nutrient utilization

An antihypertensive medication has been prescribed for an older patient with hypertension. The patient tells a clinic nurse that he would like to take an herbal substance to help lower his blood pressure instead of the prescription medication. Which of the following should the nurse do? (Select all that apply.) a. Tell the patient that herbal substances are less effective than prescription medications. b. Encourage the patient to discuss the use of an herbal substance with his primary care provider. c. Explore with the patient which herbal substance he is planning on taking. d. Educate the patient on possible interactions of the herbal substance with his other medications. e. Instruct the patient not to take the herbal substance, as it is dangerous.

b. Encourage the patient to discuss the use of an herbal substance with his primary care provider. c. Explore with the patient which herbal substance he is planning on taking. d. Educate the patient on possible interactions of the herbal substance with his other medications.

When performing the initial assessment on a new client in a geriatric outpatients practice, the most effective method the nurse can implement to elicit an accurate medication assessment is to ask that the client: a. make a list of all her current medications. b. work with a family member to make a list of her medications. c. bring in all of the medications that she is currently taking. d. allow her previous primary care provider to provide a list of medications.

bring in all of the medications that she is currently taking

A nurse utilizes the SPICES tool (Sleep disorders, Problems with eating, Incontinence, Confusion, Evidence of falls, and Skin breakdown) to assess an older female patient in the hospital. The nurse notes that the patient has new onset urinary incontinence. The first action by the nurse is to: a. conduct a more in-depth focused assessment of the urinary incontinence. b. call the provider and obtain an order for an antibiotic for a suspected urinary tract infection. c. send a urine specimen for culture and sensitivity. d. develop a plan of care with the patient to control episodes of incontinence.

conduct a more in-depth focused assessment urinary incontinence

A nurse completes a cultural assessment of an older adult who is being admitted to an assisted living facility. Reasons for completing a cultural assessment include: (Select all that apply.) a. culture guides decision-making about health, illness, and preventive care. b. culture provides direction for individuals on how to interact during health care encounters. c. culture impacts attitudes toward aging. d. all members of a culture react in the same way in similar situations. e. knowledge of culture eliminates health care disparities.

culture guides decision-making about health, illness, and preventive care. culture provides direction for individuals on how to interact during health care encounters. culture impacts attitudes toward aging.

A nurse is caring for an 85-year-old male client with diabetes in a community setting. The nurse promotes functional wellness by which of the following activities? a. Encouraging the client to maintain current levels of physical activity b. Assisting the client to receive all the recommended preventive screenings that are appropriate for his age-group c. Teaching the patient how to use a rolling walker so that he can ambulate for longer distances d. Encouraging the client to attend his weekly chess games

encouraging the client to maintain current levels of physical activity

An older adult client shares with the nurse that, "I don't know what it is but it seems that I need more light for reading or even watching television as I get older." The nurse explains that aging may cause this change due to the: a. yellowing of the lens. b. impact arcus senilis has on visual acuity c. flattening and thinning of the cornea. d. retinal changes that begin to occur with aging.

yellowing of the lens

A nurse is assessing an older patient and notes a cluster of fluid-filled vesicles on the right thoracic area. The nurse suspects HZ. The patient asks the nurse, "I really don't understand how I got shingles. I don't even know anyone who has this infection." The nurse includes which of the following in formulating a response to the patient? a. HZ is caused by a reactivation of dormant varicella zoster virus within the sensory neuron of the dorsal root ganglion. b. HZ is caused by the same virus as chickenpox and requires exposure to an individual with active chickenpox. c. HZ is caused by the same virus as chickenpox and requires direct contact with an individual with HZ. d. HZ is caused by the varicella zoster virus and occurs only in individuals who were never previously exposed to the virus.

HZ is caused by a reactivation of dormant varicella zoster virus within the sensory neuron of the dorsal root ganglion.

A nursing student is preparing a presentation on the wellness-based model for healthy aging. Which of the following concepts should the student include in the presentation? (Select all that apply.) a. Healthy aging is defined by the absence of physical illness alone. b. Healthy aging is individually defined and can change over time. c. There are many strategies to promote healthy aging that are believed to be helpful but do not have empirical evidence to support them. d. Healthy aging cannot be achieved by only focusing on later life. It is a lifelong process. e. According to this model, an individual with a chronic disease would not be

Healthy aging is individually defined and can change over time. There are many strategies to promote healthy aging that are believed to be helpful but do not have empirical evidence to support them. Healthy aging cannot be achieved by only focusing on later life. It is a lifelong process.

A nurse is preparing to hand feed an older adult with a history of a right cerebrovascular accident (CVA) with facial weakness and dysphagia. Which techniques should the nurse utilize when feeding this patient? (Select all that apply.) a. Sit the patient upright in a chair at 90 degrees. b. Allow the patient to sit upright for 15 minutes after the meal is completed. c. Feed the patient only liquids to make swallowing easier. d. Place the solid food in the left side of the mouth. e. Have the patient swallow twice for every mouthful of food given.

Sit the patient upright in a chair at 90 degrees. Have the patient swallow twice for every mouthful of food given.

The nurse's first response when told by a client during an assessment interview that he "can't take furosemide (Lasix)" is to ask: a. "Is your health care provider aware that you are allergic to Lasix?" b. "Can you describe what happened when you took Lasix?" c. "When was the last time you took Lasix?" d. "Have you any questions regarding your reaction to Lasix?"

"Can you describe what happened when you took Lasix ?"

The nurse shows an understanding of how telomeres relate to aging and longevity when stating: (Select all that apply.) a. "Healthy lifestyle choices lengthen telomeres as we age." b. "Cigarette smoking affects longevity by accelerating telomere shortening." c. "Telomere shortening due to obesity can reduce life expectancy by more than 8 years." d. "Excessive emotional stress reduces antioxidant levels resulting in shorter telomeres which reduces longevity." e. "Shorter telomeres increase vulnerability to early-onset of age-related health problems."

"Cigarette smoking affects longevity by accelerating telomere shortening." "Telomere shortening due to obesity can reduce life expectancy by more than 8 years." "Excessive emotional stress reduces antioxidant levels resulting in shorter telomeres which reduces longevity." "Shorter telomeres increase vulnerability to early-onset of age-related health problems."

A home care nurse is caring for an older patient from a different culture who is bed-bound and high risk for development of a pressure ulcer. The nurse discusses the plan of care with the patient's daughter, emphasizing the importance of turning every 2 hours and posts a turning clock on the wall. When the nurse returns later in the week, the turning clock has been removed, and the patient's daughter reports that she turns her mother occasionally. She states, "I am taking very good care of my mother. You just don't understand; our ways do not involve doing things on schedules." The best response by the nurse is: a. "You must follow my guidelines and turn her every 2 hours, or I will not be able to take care of her." b. "I understand that you value your culture, but culture cannot stop you from providing good care to your mother." c. "I understand that you care very much for your mother. Perhaps caring for her is too much for you." d. "How can we best work together to provide the best care for your mother?"

"How can we best work together to provide the best care for your mother?"

A nurse demonstrates understanding of the continuity theory when the nurse provides which of the following advice to an older client? (Select all that apply.) a. "It is important to think about the activities that have been most satisfying for you throughout your adult life and make a plan to continue them." b. "Since you enjoyed teaching young children so much, perhaps you would enjoy volunteering in the day care center." c. "It is important to save enough money so that you will have an adequate income during retirement." d. "It is important to maintain an active lifestyle as you age." e. "As you get older, it is natural to slowly disengage oneself from many activities."

"It is important to think about the activities that have been most satisfying for you throughout your adult life and make a plan to continue them." "Since you enjoyed teaching young children so much, perhaps you would enjoy volunteering in the day care center."

An older adult who is within a normal weight range asks a nurse, "I have heard that it is important to limit the amount of fats in my diet, but I don't know how much I should be taking in daily. Can you help me?" The best response by the nurse is: a. "Someone of your age needs to limit fats." b. "Less than 10% of calories per day should come from saturated fats." c. "Fat intake will depend on the presence of any cardiac issues." d. "Read food labels well and focus your diet on low-fat foods."

"Less than 10% of calories per day should come from saturated fats."

An older resident in a senior community tells a nurse: "I am really worried. I joined an exercise class, and I just learned everyone's name yesterday, and I cannot remember them all today. Am I developing Alzheimer's disease?" The best response by the nurse is: a. "You should be concerned. It is very unusual to forget something that you just learned." b. "Let's monitor your recall abilities to see if the problem persists." c. "Don't worry, a decline in both short- and long-term memory is a normal part of getting older." d. "Although it is normal to have some changes in memory, forgetting names is very unusual."

"Let's monitor your recall abilities to see if the problem persists."

The son of a nursing home resident asks a nurse: "What is the significance of being certified in gerontology? I see that you are, but not all of the nurses are." The best response by the nurse is which of the following? a. "National certification as a gerontological nurse is a way to demonstrate special knowledge in caring for older adults." b. "National certification in gerontology is required for all nurses who have worked in this setting for 2 or more years." c. "National certification is only available to nurses who have a Baccalaureate degree in nursing." d. "Only advanced practice nurses, like nurse practitioners, are certified in gerontology."

"National certification as a gerontological nurse is a way to demonstrate special knowledge in caring for older adults."

An older person is admitted to the hospital with an exacerbation of congestive heart failure. The nurse notes that the patient complains of severe itching at night and has a red rash on her torso. The patient is diagnosed with scabies. The patient asks the nurse, "How did I get something like this?" The best response by the nurse is: a. "Scabies is highly contagious and spreads easily through physical contact. b. Zostavax is recommended for all individuals over age 60 that have no contraindications to the vaccine. b. "Scabies is commonly seen in older adults due to normal age-related changes in the skin." c. "Scabies is only seen in older adults who have multiple chronic illnesses." d. "Certain medications can make you more susceptible to contracting scabies."

"Scabies is highly contagious and spreads easily through physical contact."

A nurse identifies that an older adult needs more education on nutritional needs when the older adult states the following: a. "Since I am an older person, I need more calories because my metabolic rate is slower." b. "Since I am an older person, I need fewer calories since my metabolic rate is slower." c. "Even though I am an older person, I still need the same amount of nutrients in order to be healthy." d. "Even though I am an older person, I still need to pay attention to my diet and activity levels."

"Since I am an older person, I need more calories because my metabolic rate is slower."

A nurse interviews for a job in a hospital that advertises that it is "elderly friendly." The nurse would expect to see which of the following in place? (Select all that apply.) a. An elder-assistance program to help patients remember their appointments and navigate the hospital services. b. A long-term care facility that is affiliated with the hospital. c. Rooms furnished with foldout beds for family members/caregivers. d. An initiative to provide gerontological education for all nurses. e. An initiative to increase the number of patients referred to long-term care facilities upon discharge from the hospital.

An elder-assistance program to help patients remember their appointments and navigate the hospital services. Rooms furnished with foldout beds for family members/caregivers An initiative to provide gerontological education for all nurses.

You have four rooms to choose from for your older client to be admitted this afternoon. Which room would you choose? a. A brightly lit, blue room with cozy throw rugs b. An orange-carpeted room with soft lighting and yellow walls c. A brightly lit, blue room with an EZ-Glide wax floor d. A fluorescent-lighted room with green walls and a glossy, tiled floor

An orange-carpeted room with soft lighting and yellow walls

An older adult asks a nurse, "I hear a lot about getting enough fruits and vegetables in my diet and eating a balanced diet. It is confusing. Can you help me understand what a balanced diet for me would be?" The nurse bases a response on which of the following? a. Daily intake should consist of 25% fruits and vegetables; 25% grains; and 50% protein-rich foods. b. Daily intake should consist of 50% fruits and vegetables; 25% grains; and 25% protein-rich foods. c. Daily intake should consist of 33% fruits and vegetables; 33% grains; and 33% protein-rich foods. d. Daily intake should consist of 40% fruits and vegetables; 30% grains; and 30% protein-rich foods.

Daily intake should consist of 50% fruits and vegetables; 25% grains; and 25% protein-rich foods.

Current initiatives to enhance the specialty of gerontological nursing include which of the following? (Select all that apply.) a. Mandation of a minimum of a Baccalaureate degree in nursing in order to care for older adults b. Development of the Nurse Competence in Aging project c. Promotion of geriatric nursing to excellence to the nursing community d. Developing a nursing certification specific to long-term care e. Offering scholarships for study and research in geriatric nursing

Development of the Nurse Competence in Aging project Promotion of geriatric nursing to excellence to the nursing community Offering scholarships for study and research in geriatric nursing

An older female resident of an assisted living facility says the following to a nurse: "I am very frightened about getting dementia. I have read a lot about brain exercises, but I am not sure what I should be doing." The nurse formulates a response based on knowledge of which of the following? (Select all that apply.) a. Individuals should engage in some type of brain exercising activity a couple of times a week for at least 25 minutes. b. Brain exercising activities are only effective if an individual has not experienced any memory problems at all. c. Brain exercising activities may include computer-based games, memory training, board games, reading, and engaging in conversation. d. Physical activity is important for wellness but is unrelated to brain health. e. Individuals should choose brain exercise activities that are unfamiliar, challenging, and fun.

Individuals should engage in some type of brain exercising activity a couple of times a week for at least 25 minutes. Brain exercising activities may include computer-based games, memory training, board games, reading, and engaging in conversation. Individuals should choose brain exercise activities that are unfamiliar, challenging, and fun.

A nurse is planning an education program on wellness in a local senior citizen center. The nurse plans to provide education on the importance of immunizations, annual physical examinations, screening for diabetes, and vision and hearing screening. It is important for the nurse to understand which of the following? a. Less than 50% of older adults (ages 65 and older) utilize available preventive services. b. Preventive strategies are more widely used in the 50-64 age-group than in the 65 and over age-group. c. The research on health promotion strategies in older adults demonstrates that they have low efficacy. d. There is an abundance of research specific to health promotion and aging.

Less than 50% of older adults (ages 65 and older) utilize available preventive services

A nurse is educating a group of nursing assistants in long-term care on the prevention of skin tears. Which of the following interventions should the nurse include in the education? (Select all that apply.) a. Lubricate the resident's skin with moisturizers twice daily. b. Ensure that the resident has adequate nutrition and hydration. c. Bathe the resident in hot soapy water. d. Avoid the use of lifting sheets when transferring the resident. e. Dress the resident in long sleeves and long pants to protect the extremities.

Lubricate the resident's skin with moisturizers twice daily. Ensure that the resident has adequate nutrition and hydration. Dress the resident in long sleeves and long pants to protect the extremities.

An older patient learns that he has metastatic cancer. The patient states: "I must have angered God." This is an example of which type of belief? a. Biomedical b. Magico-religious c. Naturalistic d. Ayurvedic

Magico-religious

A nurse is planning a fall prevention education refresher session for the residents of a long-term care facility. The individuals are all cognitively intact and range in age from 80 to 100. The previous education on fall prevention was presented 2 months ago. What special considerations should the nurse take in relation to teaching this group of older adults? (Select all that apply.) a. Make sure that all pamphlets are in large readable font (14-16 points) and include upper and lower case lettering. b. Start education on falls from the beginning. It is unlikely that anyone remembers previous material. c. Present all the information at once in one long session. d. Ensure that there is adequate lighting in the room and that the temperature is comfortable. e. Provide ongoing positive feedback during the session.

Make sure that all pamphlets are in large readable font (14-16 points) and include upper and lower case lettering. Ensure that there is adequate lighting in the room and that the temperature is comfortable. Provide ongoing positive feedback during the session.

The daughter of an older hospitalized patient tells a nurse: "I am worried about my father. His memory is sharper when he is at home. He is forgetful, but is functional. Since he has been hospitalized his memory problems are much worse." The best response by the nurse is: a. "It is common for long-term memory to be more impacted by age-related changes than short-term memory." b. "Memory changes are often worse when an individual is in an unfamiliar or stressful situation." c. "Perhaps you are just noticing your father's memory loss now that he is hospitalized." d. "There is a lot of new information for your father to process here in the hospital; he is overloaded."

Memory changes are often worse when an individual is in an unfamiliar or stressful situation

A nurse is planning care for a group of super-centenarians in an assisted living facility. The nurse considers which of the following ? a. Most super-centenarians are functionally independent or require minimal assistance with activities of daily living b. The majority of super-centenarians have cognitive impairment c. The number of super-centenarians is expected to decrease in coming years as a result of heart disease and stroke d. It is theorized that super-centenarians survived as long as they have due to genetic mutations that made them less susceptible to common diseases

Most super-centenarians are functionally independent or require minimal assistance with activities of daily living

Many older adults have a vitamin B12 deficiency. Reasons for this include which of the following? (Select all that apply.) a. Normal age-related changes in the stomach include a lower production of gastric acid making vitamin B12 absorption less efficient. b. The major source of vitamin B12 is sunlight, and older adults are less likely to be outdoors and absorb vitamin B12 in this manner. c. Proton pump inhibitors, a frequently prescribed medication in older adults, impairs absorption of vitamin B12 from food. d. Most older adults do not consume five servings of fruits and vegetables daily, which is the main dietary source of vitamin B12. e. Vegetarian diets increase the risk of vitamin B12 deficiency.

Normal age-related changes in the stomach include a lower production of gastric acid making vitamin B12 absorption less efficient. . Proton pump inhibitors, a frequently prescribed medication in older adults, impairs absorption of vitamin B12 from food. Vegetarian diets increase the risk of vitamin B12 deficiency.

A resident of a long-term care facility is assessed by a nurse upon admission to the facility. The assessment includes a comprehensive health, social, and functional profile. The tool that the nurse utilizes is: a. Outcomes and Assessment Information Set (OASIS). b. Resident Assessment Instrument (RAI). c. Older Americans Resources and Services (OARS). d. Comprehensive Geriatric Assessment (CGS). e. Mini Mental Status Examination (MMSE).

Outcomes and Assessment Information Set (OASIS)

An older patient is diagnosed with diabetic retinopathy. The patient asks a nurse: "Is there anything that I can do to prevent progression of this disease and blindness?" The nurse includes which of the following into the response? (Select all that apply.) a. Strict control of blood glucose levels is important in slowing disease progression. b. Laser photocoagulation treatments can stop progression of the disease. c. Control of blood pressure and cholesterol levels are important steps slowing disease progression. d. Wearing sunglasses to protect the eyes from ultraviolet light can stop disease progression. e. Eating a diet high in beta-carotene can stop disease progression.

Strict control of blood glucose levels is important in slowing disease progression. Laser photocoagulation treatments can stop progression of the disease. Control of blood pressure and cholesterol levels are important steps slowing disease progression.

Ethnocentrism is defined as: a. an understanding of another's cultural beliefs and practices. b. a conflict that occurs when an individual interacts with another whose beliefs differ from his own. c. application of limited knowledge about one person with characteristics specific to another person. d. a belief that one's ethnic group is superior to that of another.

a belief that one's ethnic group is superior to that of another

An older client prescribed a transdermal morphine patch for severe chronic pain is being educated on the appropriate administration of the medication. The nurse shows an understanding of essential information regarding this route of drug administration when stating: (Select all that apply.) a. "This is an effective route for delivering small doses of medication over long periods of time." b. "Since you have problems with digestion, this is a good way to take your medication." c. "Please show me how you would apply your patch." d. "Be careful to put the patch only on your chest but change locations with each application." e. "Be sure to avoid placing the patch on injured skin."

a. "This is an effective route for delivering small doses of medication over long periods of time." b. "Since you have problems with digestion, this is a good way to take your medication." c. "Please show me how you would apply your patch." e. "Be sure to avoid placing the patch on injured skin."

A 77-year-old Hispanic Catholic nun (retired) who immigrated to the United States 15 years ago lives alone but in an apartment complex where her biological sister lives as well. She is being discharged home after a hospitalization for congestive heart failure with prescriptions for eight different medications. She is considered at risk for medication misuse due to contributing factors that include: a. language barrier. b. living alone. c. large number of medications. d. ethnic background. e. religious background.

a. language barrier. b. living alone. c. large number of medications.

What factor is an important contribution to polypharmacy in older adults? a. Inadequate communication among medical care providers b. Implementation of Medicare Part D prescription drug benefit c. Use of generic medications d. Increasing popularity of dietary and herbal supplements

inadequate communication among medical care providers

A 78-year-old man is being evaluated in the geriatric clinic. His daughter reports that he has been very forgetful lately, and she is concerned that he might be "senile." The advanced practice nurse administers the clock-drawing test and the patient draws a distorted circular shape and places the numbers all on one side of the shape. Based on his performance, the nurse concludes that the patient: a. probably has Alzheimer's disease. b. needs further evaluation. c. probably has delirium. d. needs a functional status assessment.

needs further evaluation

A nurse assesses a nursing home resident's pressure injury to be a "healing stage III." The primary reason reverse staging is never used is because: a. even though all tissue layers are replaced as a wound heals, the healed skin is not as strong as it originally was. b. not all tissue layers are replaced as a wound heals, and the healed skin is not as strong as it originally was. c. reimbursement in nursing homes does not allow for reverse staging to be utilized. d. the collagen layer is not replaced during wound healing.

not all tissue layers are replaced as a wound heals, and the healed skin is not as strong as it originally was

A nurse hears a colleague state the following: "Can you believe that Mr. Jones' daughter just bought him a tablet computer? He is 90 years old. It is ridiculous to think that he can learn to use it." The nurse formulates a response based on research that shows: (Select all that apply.) a. older adults comprise the fastest growing population using computers and the Internet. b. Internet use is less prevalent in individuals over age 75 than those ages 65-74. c. older American men are the fastest growing group of social networking site users. d. older adults use the Internet only for social networking and recreational uses. e. technology has the potential to improve quality of life for older adults.

older adults comprise the fastest growing population using computers and the Internet. Internet use is less prevalent in individuals over age 75 than those ages 65-74. technology has the potential to improve quality of life for older adults.

Gerotranscendence theory posits that: (Select all that apply.) a. older adults withdraw from society in order to allow the transfer of power to younger individuals. b. older adults withdraw from society in order to give the individual an opportunity for self-reflection and self-exploration. c. time and superficial relationships become less important. d. material possessions have less meaning. e. status and value of elders is lost because their contributions are no longer valued.

older adults withdraw from society in order to give the individual an opportunity for self-reflection and self-exploration. time and superficial relationships become less important. material possessions have less meaning.

Serious and well-controlled research studies on aging have been available: a. only in the past 60 years. b. since the turn of the 20th century. c. following the Great Depression. d. since the year 2000.

only in the past 60 years

When developing a teaching plan for an older, newly diagnosed diabetic client, the nurse best ensures an understanding of oral hypoglycemic medications when providing: a. the package insert and assessing the client's reading skills. b. the client with the website address for the American Diabetes Association. c. oral explanations and sending the client home with a written copy. d. the information in paragraph form as opposed to numbered line fashion.

oral explanations and sending the client home with a written copy

An older adult's nutritional status is screened by a nurse using the Mini Nutritional Assessment (MNA). The older adult scores a "7" (risk for malnutrition) on the screening portion of the tool. The best action by the nurse is to: a. offer high calorie meals. b. perform a comprehensive nutritional assessment. c. conduct a 72-hour calorie count. d. initiate nutritional supplements between meals.

perform a comprehensive nutritional assessment

Factors that complicate assessment of older adults include: (Select all that apply.) a. presence of multiple comorbid conditions. b. atypical presentation of illness. c. difficulty in differentiating symptoms of disease from normal age-related changes. d. increase in iatrogenic illness. e. lack of assessment instruments specific for the older adult population.

presence of multiple comorbid conditions. atypical presentation of illness. difficulty in differentiating symptoms of disease from normal age-related changes. increase in iatrogenic illness.

The nurse in a clinic setting that provides care for an ethnically diverse population of older clients shows an understanding of the LEARN Model to direct the assessment process when: (Select all that apply.) a. recognizing that the client's hands are clenched as she answers the assessment questions. b. asking the client to describe what he thinks will help him feel better. c. explaining to the client that herbal remedies may not be sufficient treatment for his chest congestion. d. acknowledging that the client has a different view of the appropriate treatment. e. suggesting to the client that it would be beneficial if she would trust her health care provider to prescribe the correct treatment.

recognizing that the client's hands are clenched as she answers the assessment questions. asking the client to describe what he thinks will help him feel better. explaining to the client that herbal remedies may not be sufficient treatment for his chest congestion. acknowledging that the client has a different view of the appropriate treatment. e. suggesting to the client that it would be beneficial if she would trust her health care provider to prescribe the correct treatment.

The nurse preparing wellness information for older adult clients is promoting interventions consistent with healthy biological aging when suggesting that they: (Select all that apply.) a. use moisturizers daily to minimize dry skin. b. discuss the use of antioxidant supplements to increase immunity with their health care provider. c. stay active by interacting with family and friends regularly. d. practice stress reduction techniques on a regular basis. e. consider getting a yearly influenza vaccination

use moisturizers daily to minimize dry skin. practice stress reduction techniques on a regular basis. consider getting a yearly influenza vaccination.